The effect of radiofrequency ablation on cardiac systolic and diastolic function of left ventricle in patients with cardiac insufficiency caused by ventricular arrhythmias

Objective To investigate whether cardiac systolic function of left ventricle improved significantly after radiofrequency ablation in patients with earlier cardiac insufficiency caused by ventricular arrhythmias. Methods This prospective observational study included 22 patients who suffered from ventricular arrhythmias [premature ventricular contraction (PVC) , ventricular tachycardia (VT) ] , and received radiofrequency ablation treatment in Department of Cardiology in the First Affiliated Hospital of Nanjing Medical University from December 2015 to December 2018. Transthoracic echocardiography was used to evaluate cardiac systolic function [left ventricular end diastolic dimension (LVEDD) , left ventricular end systolic dimension (LVESD) , left ventricular ejection fraction (LVEF) ] , and diastolic function [the ratio of early transmitral flow velocity (E) to early mitral annular velocity (Em) (E/Em) ] at the times before ablation procedure, then 3rd day, and 1st, 2nd, 3rd, 6th, 12th month after ablation procedure, respectively. Holter recording was performed at every follow-up time point. Results This study included 22 patients (11 men) , median 38 years old (27-49 years old) , who suffered from ventricular arrhythmias. Ablation was successful in all patients (PVC, n=21, VT, n=1) . There was no significant difference of LVEDD, LVESD and LVEF between the 3rd day after ablation procedure and baseline [LVEDD: (57.2±5.2) mm vs. (56.7±4.2) mm, P>0.05; LVESD: (41.2±6.3) mm vs. (40.5±3.7) mm, P>0.05; LVEF: 54.4%±7.6% vs. 54.7%±4.7%, P>0.05; respectively] . There was significant difference of LVEDD, LVESD and LVEF between the 1st month after ablation procedure and baseline [LVEDD: (53.5±3.2) mm vs. (56.7±4.2) mm, P 0.05, respectively) .There was significant difference of E/Em at the 2nd, 3rd and 12th month after ablation procedure compared with the 3rd day after ablation procedure (Pall>0.05, respectively) . PVC reoccurred in one patient.Repeated ablation procedure was successful. Follow-up was lost in three patients at the 12th month after ablation procedure. Conclusion The cardiac systolic and diastolic function of left ventricle improved significantly at the 1st month after radiofrequency ablation procedure in patients with earlier cardiac insufficiency caused by ventricular arrhythmias. Key words: Catheter ablation; Ventricular premature complexes; Tachycardia, ventricular; Arrhythmia induced cardiomyopathy