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Title: Aavaliação do remodelamento reverso do átrio esquerdo após ablação da fibrilação atrial
Other Titles: Assesment of Left Atrial Reverse Remodeling After Atrial Fibrillation Ablation
Keywords: Fibrilação atrial;  Remodelamento atrial;  Ablação;  Ressonância nuclear magnética;  Ablação por cateter;  Remodelação ventricular;  MEDICINA
Issue Date: 30-Dec-2008
Abstract: Introduction: Atrial fibrillation is the most common sustained arrhythmia in clinical practice. During the course take place a mechanical remodelling causing left atrial dilatation. Recently, catheter ablation has emerged as effective therapy for atrial fibrillation (AF) refractory to medical therapy and reverse remodeling has been observed. Objective: To evaluate left atrial reverse remodeling after ablation AF and compare with early recurrence. Methods: From February, 2005 to November 2006 we follow 41 patients, 35 were male, submitted to AF ablation. The magnetic resonance angiography was accomplished before, 30 and 90 days after the procedure by the Philips Gyroscam machine 1.0(Intera) and the pictures edited at the workstation Ph Easyvision. The dimension (volume) left atrial (LA) was calculated based at the measurement anterior, transverse and skullstream. Recurrence was available by arrhythmia recorded in ekg, Holter and Recorder events, associated or not to symptoms. Results: Patients had a mean age of 59, 4 ± 9, 3 years. The population was divided into the following two groups: paroxysmal (21 patients) and persistent (20 patients). The left atrial volume in paroxysmal group decreased from 67, 7 ± 23 to 62, 3 ±11 (p>0,005). In persistent group the left atrial volume increased from 97, 7 ±30, 2 to 81, 6 ± 28, 3 (p>0,005). LA dimension in the 32 patients who remained in sinus rhythm decreased from 83, 6 to 68, 8 (p=0,018). In patients with recurrences of AF - 9 pts (22, 5%) - we observed a LA increase from 80, 4 to 86, 6 (p>0,005). Conclusion: Patients with AF persistent showed up left atrial reverse remodeling evident at the end of 90 days. This modification was more evident in patients who developed without atrial arrhythmia recurrence. Then, reverse remodeling may be a sign of favourable evolution after atrial fibrillation ablation.
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