Functional improvement after successful catheter ablation for long-standing persistent atrial fibrillation
Language English Country Great Britain, England Media print
Document type Journal Article
PubMed
27707782
DOI
10.1093/europace/euw282
PII: euw282
Knihovny.cz E-resources
- Keywords
- Atrial fibrillation, Catheter ablation, Long-standing persistent, Outcome,
- MeSH
- Anti-Arrhythmia Agents therapeutic use MeSH
- Biomarkers blood MeSH
- Time Factors MeSH
- Adult MeSH
- Atrial Fibrillation diagnosis physiopathology surgery MeSH
- Ventricular Function, Left * MeSH
- Catheter Ablation * adverse effects MeSH
- Quality of Life MeSH
- Middle Aged MeSH
- Humans MeSH
- Multivariate Analysis MeSH
- Natriuretic Peptide, Brain blood MeSH
- Recovery of Function MeSH
- Peptide Fragments blood MeSH
- Prospective Studies MeSH
- Surveys and Questionnaires MeSH
- Registries MeSH
- Risk Factors MeSH
- Chi-Square Distribution MeSH
- Aged MeSH
- Sex Factors MeSH
- Oxygen Consumption MeSH
- Atrial Function, Left * MeSH
- Stroke Volume MeSH
- Exercise Tolerance * MeSH
- Age Factors MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Anti-Arrhythmia Agents MeSH
- Biomarkers MeSH
- Natriuretic Peptide, Brain MeSH
- Peptide Fragments MeSH
- pro-brain natriuretic peptide (1-76) MeSH Browser
AIMS: Identifying patients who benefit from restored sinus rhythm (SR) would optimize the selection of candidates for ablation of long-standing persistent atrial fibrillation (LSPAF). This prospective study sought to identify the hitherto unknown factors associated with global functional improvement after successful radiofrequency catheter ablation of LSPAF. METHODS AND RESULTS: In 171 LSPAF patients (84% of the total consecutive 203 patients) who were examined in SR 12 months after ablation, the individual per cent change from baseline value in maximum oxygen consumption at exercise test (VO2 max), left ventricular ejection fraction (LVEF), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), and five-dimensional descriptive system (EQ-5D) of quality-of-life questionnaire were classified in quartiles by 0 (worse) to 3 (best) grades. The individual grades were summed into a composite score (SCORE, 0 … 12) reflecting global functional improvement. Significant improvement in VO2 max (3.4 ± 4.7 mL/kg/min), LVEF (7.5 ± 9.1%), NT-proBNP (-861 ± 809 pg/mL), and EQ-5D (0.7 ± 0.12) was observed (all P < 0.0001). On multivariable analysis, younger age (P = 0.001), male gender (P = 0.02), timely post-ablation left atrial appendage (LAA) outflow (P = 0.005) with improvement in outflow velocity (P = 0.0002), and withdrawal of Class I/III antiarrhythmic drugs (P < 0.05) were positively and independently correlated with the SCORE. CONCLUSIONS: Younger male patients benefited most from catheter ablation of LSPAF. Delayed or non-improved LAA outflow and inability to discontinue Class I/III antiarrhythmic medication reduced the post-ablation functional improvement.
Department of Cardiology Hospital Podlesí Trinec Czech Republic
Department of Cardiology Hospital Podlesí Třinec Czech Republic
Department of Cardiology Institute for Clinical and Experimental Medicine Prague Czech Republic
References provided by Crossref.org
Catheter Ablation for Persistent and Long-Standing Persistent Atrial Fibrillation
