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European Heart Journal Advance Access originally published online on December 11, 2007
European Heart Journal 2008 29(10):1290-1295; doi:10.1093/eurheartj/ehm577
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2007. For permissions please email: journals.permissions@oxfordjournals.org

Chronic atrial fibrillation ablation impact on endocrine and mechanical cardiac functions

Frédéric Sacher1,*, Jean-Benoît Corcuff2, Philippe Schraub3, Valérie Le Bouffos3, Agnès Georges2, Samuel O. Jones1, Stéphane Lafitte3, Pierre Bordachar1, Mélèze Hocini1, Jacques Clémenty1, Michel Haissaguerre1, Laurence Bordenave2, Raymond Roudaut3 and Pierre Jaïs1

1 Service de Rythmologie, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux/Université Bordeaux II, Bordeaux-Pessac, France
2 Service de Médecine Nucléaire, CHU de Bordeaux/Université Bordeaux II, France
3 Service d'Echocardiographie, CHU de Bordeaux/Université Bordeaux II, France

Received 16 May 2007; revised 26 October 2007; accepted 15 November 2007; online publish-ahead-of-print 11 December 2007.

* Corresponding author: Tel: +33 5 57656471, Fax: +33 5 57656509. E-mail: frederic.sacher{at}chu-bordeaux.fr

Aims: Assess the impact of persistent/permanent atrial fibrillation (AF) ablation on endocrine and mechanical cardiac functions.

Methods and results: In all, 43 patients (40 males, 53 ± 12 years) undergoing persistent/permanent AF ablation had atrial (ANP) and brain natriuretic peptide (BNP) measurements before day 1, 3, and 3 months after ablation. In the same period of time transthoracic echocardiography was performed. With a mean radiofrequency delivery of 98 ± 29 min, sinus rhythm (SR) was restored in 30 patients (70%) without DC shock. ANP decreased significantly (P < 0.001) with restoration of SR and then increased until day 3 post ablation without reaching the level observed during AF. At 3 months, ANP was significantly lower than day 3 reaching normal value in 28 (65%) patients and being <7 pg/mL in 4 (9%). The BNP followed the same trend with normal BNP level in 23 (53%) patients at 3 months. Identifiable atrial filling waves on the pulsed Doppler transmitral recordings performed between day 2 and day 4 after the procedure were seen in 18 patients (42%). At 3 months, 39 (95%) of the patients with SR during echocardiography had a significant A wave.

Conclusion: SR following persistent/permanent AF ablation is associated with a dramatic decrease in natriuretic peptides. At 3 months, despite relatively extensive atrial ablation, endocrine and mechanical cardiac functions are significantly improved.

Key Words: Chronic atrial fibrillation • Catheter ablation • Natriuretic peptides • ANP • BNP • Cardiac function


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