Restoration of Impaired Cardiac Function in Patients with Dilated Cardiomyopathy after the Radiofrequency Catheter Ablation of Long-Standing Persistent Atrial Fibrillation with Adequate Ventricular Rate Control

Tachycardia induced cardiomyopathy is a well-known form of reversible cardiac dysfunction; however, the effect of maintaining sinus rhythm by a radiofrequency Catheter ablation (RFCA) in patients with impaired cardiac function and adequately rate-controlled atrial fibrillation (AF) is unclear. Six patients (54±9 years old, 5 men) with drug-resistant persistent AF (lasting 21 ± 14 months) combined with dilated cardiomyopathy (DCM) had suffered from heart failure for more than one year in spite of an adequate ventricular rate control (̼90 bpm) and intensive medications including angiotensin converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, diuretics, and an amiodarone. All patients underwent the RFCA of AF and were maintained in sinus rhythm during a mean follow-up period of 14± 19 months. The left ventricular ejection fraction increased from 32±8 % to 60±8 %, the left atrial diameter decreased from 50±8 mm to 48± 10 mm, and the BNP decreased from 302 ±166 pg/ml to 56± 79 pg/ml at the end of the follow-up period. The RFCA of AF may provide a chance to restore an impaired cardiac function in patients who have already diagnosed as DCM with adequately rate-controlled persistent AF.