Left Ventricular Diastolic Function and Right Atrial Size Are Important Rhythm Outcome Predictors after Intraoperative Ablation for Atrial Fibrillation


Address for correspondence and reprint requests: Birgitta Houltz, M.D., Ph.D., Respiratory Physiology, Pulmonary Medicine and Allergology, Sahlgrenska University Hospital, S-413 45 Gothenburg, Sweden. Fax: 46-31-827138; E-mail: birgitta.houltz@medfak.gu.se; birgitta.houltz@vgregion.se


Background: Left ventricular (LV) diastolic function and right atrial (RA) size are not routinely included in preoperative echocardiographic examination in patients undergoing cardiac surgery with concomitant ablation for atrial fibrillation (AF). Objective: To investigate the role of echocardiographic variables including LV diastolic function and RA area in long-term rhythm outcome prediction, in patients with documented AF undergoing intraoperative ablation concomitant to coronary artery bypass grafting (CABG). Methods: Thirty-five consecutive patients, scheduled for CABG, and with a history of paroxysmal or permanent AF for 8.5 ± 11.3 years (mean ± SD) (median 5.8 years), were included in this prospective study. Echocardiography was performed prior to and 2.3 ± 0.4 years after the surgical procedure. Results: Both LA and RA areas, LV diastolic function, paroxysmal AF, and sinus rhythm (SR) preoperatively were associated with SR at long-term follow-up. In the multivariate analysis, RA area (P = 0.004), and decreased LV diastolic function preoperatively, measured as the maximal LV long-axis relaxation velocity (P = 0.02), predicted SR at follow-up. Conclusions: RA size and LV diastolic function may be important variables in prediction of long-term rhythm outcome after intraoperative ablation for AF. (Echocardiography 2010;27:961-968)