Abstract| Volume 23, ISSUE 10, SUPPLEMENT , S33-S34, October 2017

Left Ventricular Reverse Remodeling following Pulmonary Vein Isolation in a Patient with Long Standing Persistent Atrial Fibrillation

      A 58-year-old male was diagnosed with persistent atrial fibrillation complicated with dilated cardiomyopathy more than 5 years ago. He was treated with anticoagulant therapy and optimal medical therapy, including β-blockers. Despite long-term medical treatment, left ventricular reverse remodeling (LVRR) did not occur. Because heart failure management became difficult (serum brain natriuretic peptide (BNP) levels of 1831 pg/ml), we performed pulmonary vein isolation (PVI) for long standing atrial fibrillation. A prominent LVRR occurred after one month (LV ejection fraction: 38 to 53%, LV diastolic dimension: 70 to 59 mm) and serum BNP levels improved (83 pg/ml). Heart failure management, such as β-blockers, has been shown to induce LVRR. In this case, LVRR did not occur using pharmacological therapy and it required a PVI. In this presentation, we will demonstrate the PVI treatment strategy for persistent atrial fibrillation patient complicated with dilated cardiomyopathy.
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