The Impact of Early Reverse Remodeling after Ablation Procedure on a Long-Term Outcome in Patients with Paroxysmal Atrial Fibrillation

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Background: Ablation for atrial fibrillation (AF) has been previously reported to improve cardiac function and decrease brain natriuretic peptide (BNP) during mid-term follow-up. However, whether the early reverse remodeling after the ablation procedure can predict a long-term outcome remains unknown. Methods: A total of 137 paroxysmal AF patients who underwent the ablation procedure was enrolled in this study. To evaluate the early cardiac reverse remodeling markers, cardiac echocardiography parameters and BNP value at 2-month after the ablation procedure were compared with those at baseline in all patients. We examined the relationship between the early reverse remodeling and a long-term clinical outcome. Results: AF recurrence was observed in 17.5% (24/137) of patients during 31±16 months follow-up period. In patients without AF recurrence, both the left atrial dimension (LAD) and BNP value significantly decreased 2-month after the ablation procedure (37.8±5.2 vs. 36.7±5.7 (P=0.001), 38.7±44.3 vs. 28.5±25.9 (P=0.006), respectively), while no remarkable change was observed in patients with recurrence of AF (LAD: 37.4±4.2 vs. 37.3±6.0 mm, P=0.91, BNP: 55.0±50 vs. 63.1±65 pg/ml, P=0.66). Conclusion: Early reverse remodeling after the ablation procedure can predict a better long-term clinical outcome in patients with catheter ablation for paroxysmal AF.