Hemodynamic changes in cardiac within 48 hours after atrial fibrillation ablation: a prospective multiparametric study

Abstract Background Atrial fibrillation (AF) is associated with significantly increased mortality and morbidity. catheter ablation (CA) effectively restores sinus rhythm and reverse left atrial remodeling with long-term follow-up. However, hemodynamic changes on early-phase remodeling involving all chambers has not been thoroughly investigated. Objectives This study aimed to evaluate the acute effects of CA on cardiac function and morphology across all chambers during the immediate post-procedural period (≤48 hours). Methods We prospectively enrolled 245 consecutive patients. 117 patients was analysized finally according to exclusion criterias. Hemodynamic parameters including bi-atrial pressure and echocardiography were acquired pre- and post-ablation. Results All LAP and RAP parameters demonstrated significant elevation post-ablation (P＜0.001). LA function including LA EF, LASr and LAScd improved early period following ablation but not LASct. Similary, RA function including RA EF, RASr and RAScd improved following ablation except LASct. Left ventricular systolic function improved early with diastolic function stunning within 48 hours. Right ventricular systolic function improved significantly following ablation with slightly diastolic stunning. All chambers function improved with static volumetric parameters. Further comparative analysis revealed no statistically significant differences in pre- versus post-procedural pressure changes between patients with persistent AF and those with paroxysmal AF in bi-atrial pressure elevation. Echocardiographic parameters including LASr, RASr, peak E and A of mitral valve, peak E of tricuspid valve and inferior vena cava diameters increased more in persistent groups post-ablation. Conclusions This research provides comprehensive hemodynamic characterization of early cardiac changes following ablation. This prospective study proved all chambers’ function improved in early priod post-ablation with ventricular diastolic function stunning. Mechanical improvements preceding structural remodeling in AF patients after ablation.