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Left Ventricular Electromechanical Remodeling Detected by Acoustic Cardiography in Paroxysmal Atrial Fibrillation

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Abstract

This study aimed to investigate the electromechanical function detected by acoustic cardiography before and after radiofrequency ablation therapy (RFA) in paroxysmal AF (PAF) patients with preserved left ventricular ejection fraction (LVEF). Seventy-five symptomatic PAF patients and 69 patients without arrhythmia were enrolled. Thirty-seven PAF patients received RFA therapy. Acoustic cardiographic exam was performed to check S3 and S4 heart sound, electromechanical activation time (EMAT), LV systolic time percentage (LVST), and systolic dysfunction index (SDI) in all participants. Furthermore, 37 PAF patients also received follow-up acoustic cardiography postRFA. PAF had impaired electromechanical systolic function compared with health participants (%EMAT 14.69 ± 3.62 vs. 10.84 ± 2.62; %LVST 40.83 ± 5.14 vs. 36.70 ± 3.87; SDI 4.75 ± 1.61 vs. 3.26 ± 0.96 all p < 0.001). RFA can improve electromechanical systolic function. Improvement below 13.1% could predict the recurrent AF postcatheter ablation. Higher degree of improved electromechanical systolic function postRFA contribute to lower recurrence of AF.

Receiver operating characteristic (ROC) curve analysis for % change of systolic dysfunction index (SDI) postRFA in the detection of recurrent AF

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Authorship

All authors contributed to the study conception and design. Material preparation and data collection were performed by Kuo-Li Pan, Yenn-Jiang Lin, Li-Wei Lo, Yu-Feng Hu, Fa-Po Chung, Tze-Fan Chao, Jo-Nan Liao, Chin-Yu Lin, Chung-Hsing Lin, Abigail Louise D. Te, Shinya Yamada, and Yao-Ting Chang. The data analysis was performed by Kuo-Li Pan and Shih-Lin Chang. The first draft of the manuscript was written by Kuo-Li Pan. This study was supervised by Shih-Ann Chen. And all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan

    Kuo-Li Pan

  2. School of Medicine, Chang Gung University, Taoyuan, Taiwan

    Kuo-Li Pan

  3. Heart Failure Center, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan

    Kuo-Li Pan

  4. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201 Section 2, Shih-Pai Road, Taipei, Taiwan

    Shih-Lin Chang, Yenn-Jiang Lin, Li-Wei Lo, Yu-Feng Hu, Fa-Po Chung, Tze-Fan Chao, Jo-Nan Liao, Chin-Yu Lin, Yao-Ting Chang & Shih-Ann Chen

  5. School of Medicine, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan

    Shih-Lin Chang, Yenn-Jiang Lin, Li-Wei Lo, Yu-Feng Hu, Fa-Po Chung, Tze-Fan Chao, Jo-Nan Liao, Chin-Yu Lin, Yao-Ting Chang & Shih-Ann Chen

  6. Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan

    Chung-Hsing Lin

  7. Heart Institute, St. Luke’s Medical Center, Quezon City, Philippines

    Abigail Louise D. Te

  8. Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan

    Shinya Yamada

Authors
  1. Kuo-Li Pan
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  2. Shih-Lin Chang
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  3. Yenn-Jiang Lin
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  4. Li-Wei Lo
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  8. Jo-Nan Liao
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  9. Chin-Yu Lin
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  10. Chung-Hsing Lin
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  11. Abigail Louise D. Te
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  12. Shinya Yamada
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  13. Yao-Ting Chang
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  14. Shih-Ann Chen
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Corresponding author

Correspondence to Shih-Lin Chang.

Ethics declarations

This study was approved by the Taipei Veterans General Hospital Institutional Review Board (IRB no: 2014-09-012A), and informed consents were obtained from healthy individuals and all symptomatic consecutive PAF patients who participated this study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Associate Editor Sunil Kapur oversaw the review of this article

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Highlights

• Symptomatic paroxysmal atrial fibrillation patients had impaired electromechanical systolic function

• Higher degree of improved electromechanical systolic function postradiofrequency ablation of paroxysmal atrial fibrillation contributed to lower recurrence of atrial fibrillation.

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Pan, KL., Chang, SL., Lin, YJ. et al. Left Ventricular Electromechanical Remodeling Detected by Acoustic Cardiography in Paroxysmal Atrial Fibrillation. J. of Cardiovasc. Trans. Res. 14, 348–354 (2021). https://doi.org/10.1007/s12265-020-10047-y

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  • DOI: https://doi.org/10.1007/s12265-020-10047-y

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