ABSENCE OF ACUTE HAEMODYNAMIC IMPROVEMENT FOLLOWING ATRIOVENTRICULAR
JUNCTION ABLATION AND VENTRICULAR PACING FOR PATIENTS WITH RATE CONTROLLED
PERMANENT ATRIAL FIBRILLATION. H.R. Weerasooriya*, A.M. Perks, C.P. Shah, T. Szili-Torok, BA. Martin,
A.C. Powell, M.J.E. Davis. Cardiology Department, Royal Perth Hospital, Perth, Western Australia. Introduction: We measured
haemodynamic parameters pre and post AV junction ablation in 9 patients (pts)
to determine the acute effects of restoration of a regular ventricular rhythm. Methods: All pts had an
echocardiogram prior to ablation and the mean ejection fraction was 62% (range
32 - 81%). Prior to ablation a
Swan-Ganz pulmonary artery catheter was inserted into the left or right
pulmonary artery. We recorded the
following haemodynamic variables immediately before and after AV junction
ablation; cardiac output, cardiac index, pulmonary capilliary wedge pressure
(PCWP), pulmonary artery pressure and invasive blood pressure. Post-ablation haemodynamic variables were
recorded at a paced rate equal to the mean pre-ablation ventricular rate. Results: Seven pts were
male. The mean age of the pts was 70yrs
(range 58 - 78yrs). There was no
significant change in any of the measured haemodynamic variables following ablation. The mean cardiac output was 5.32 ±
1.09(SD)L/min pre-ablation compared to 5.42 ± 1.23(SD)L/min post-ablation. The mean PCWP was 13 ± 7 (SD)mmHg
pre-ablation versus 16 ± 7(SD)mmHg post-ablation. Conclusion: The restoration of a regular ventricular
rhythm following AV junction ablation and pacing for pts in permanent AF with a
previously well controlled ventricular rate does not result in an acute
haemodynamic improvement.
