Impact of Radiofrequency Ablation on Left Ventricular Function in Supraventricular Tachyarrhythmias Patient Using Speckle Tracking Echocardiography

Left Ventricular Function, Arrhythmia

In this study, we aimed to evaluate atrial and ventricular function in supraventricular tachyarrhythmia patients before and 3 months after RFA using 2DSTE.

Two-dimensional speckle-tracking echocardiography (2DSTE) is a known technique for the evaluation of myocardial function in many conditions. The longitudinal deformation of the left ventricular (LV) mainly occurs in the subendocardial level which is sensitive to injury and it may be used to identify sub-clinical LV dysfunction in cardiomyopathies. Global longitudinal strain, strain rate (SR), and torsion measurements are very promising to identify patients with mild systolic and diastolic dysfunctions which are not reflected in reduced EF. Tachyarrhythmias that are persistent and recurrent can lead to LV dysfunction. Dyssynchrony is another mechanism that may cause LV dysfunction, as in the case of Wolf Parkinson Syndrome (WPW ). It might be explained by the collision of electric stimuli through the normal atrioventricular conduction system and along the accessory pathway (AP) during the systolic phase. 2DSTE has been used to investigate the characteristics of WPW syndrome and confirm the presence of LV dyssynchrony in this condition. Lelakowski et al. showed that RFA improves LV systolic and diastolic functions in patients with Atrioventricular Nodal Reentry tachycardia (AVNRT). Recurrent AVNRT attacks increase atrial pressure, leading to elevated atrial wall stress, which causes negative remodeling and systolic impairment. It has been shown that left atrial(LA) functions improved after Radiofrequency ablation RFA, along with LA volume reduction in atrial fibrillation/flutter patients. the small number of patients and lacking using advanced accurate techniques lead to currently insufficient data in the literature regarding changes in cardiac function following AVNRT & AVRT ablation and whether LV dyssynchrony is reversible after ablation therapy of AVRT or not.

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