The purpose of the study was to evaluate the radiofrequency ablation impact on the morpho-functional state of the heart in patients with atrial fibrillation and chronic heart failure with preserved ejection fraction based on 2-year follow-up. Materials and methods. The study included 194 patients with an average age of 59.3±8.5 years with atrial fibrillation and concomitant heart failure with preserved left ventricular ejection fraction of I-III functional class of New York Heart Association. Patients were divided into 2 groups: 136 patients who underwent radiofrequency catheter ablation and 58 patients in the control group who did not undergo intervention and continued antiarrhythmic pharmacotherapy. Patients were comparable in terms of basic clinical and demographic indicators. In order to assess the morpho-functional state of the heart, transthoracic echocardiography was performed at the stage of inclusion in the study and 2 years after. Results and discussion. According to the results of the analysis in the radiofrequency catheter ablation group 2 years after the intervention revealed: a statistically significant decrease in the mean end-systolic diameter of the left ventricle (3.3±0.48 cm versus 3.2±0.41cm, p <0.001); decreased size of the left atrium (4.3±0.71 cm versus 4.2±0.30 cm, p <0.001); left ventricular ejection fraction increased significantly (61.9±7.14% versus 63.9±5.65%, p <0.001); the E/e' ratio decreased statistically significantly (11.9±1.65 versus 9.4±1.48; p <0.001) and the left ventricular myocardial mass index (118.3±25.04 g/m2 versus 116.4±18.04 g/m2; p=0.045). In the pharmacotherapy group there were: a statistically significant increase in the average end-systolic size of the left ventricle (3.61±0.45 cm versus 3.63±0.41, p=0.007); statistically significant increased left atrium (4.3±0.61 cm versus 4.4±0.36; p <0.001) and the right atrium (4.1±0.52 cm versus 4.2±0.26; p <0.001); decreased left ventricular ejection fraction (58.1±6.12% versus 56.6±6.11; p <0.001); increased values of the ratio E/e' (12.1±1.63 versus 12.7±1.27; p=0.002) and decreased level of the left ventricular myocardial mass index (120.5±24.05 g/m2 versus 118.3±20.13 g/m2; p=0.044). Conclusion. Radiofrequency ablation of atrial fibrillation in patients with heart failure with preserved left ventricular ejection fraction to control sinus rhythm is associated with improved morpho-functional state of the heart at the 2-year follow-up compared with antiarrhythmic pharmacotherapy strategy: the left ventricular ejection fraction increases, the left ventricular diastolic function improves according to the E/e' value, the size of the left atrium decreases
Keywords: morpho-functional state, heart failure, ablation, atrial fibrillation
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