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Clinical significance of substrate characteristics and ablation outcomes in patients with atrial fibrillation and significant functional mitral regurgitation.
Bautista, Jose Antonio L; Lin, Chin-Yu; Lu, Chi-Ting; Lo, Li-Wei; Lin, Yenn-Jiang; Chang, Shih-Lin; Hu, Yu-Feng; Chung, Fa-Po; Tuan, Ta-Chuan; Chao, Tze-Fan; Liao, Jo-Nan; Chang, Ting-Yung; Kuo, Ling; Liu, Chih-Min; Liu, Shin-Huei; Wu, Cheng-I; Kuo, Ming-Jen; Li, Guan-Yi; Huang, Yu-Shan; Wu, Shang-Ju; Siow, Yoon Kee; Son, Ngoc Nguyen Dinh; Tran, Dat Cao; Chen, Shih-Ann.
Affiliation
  • Bautista JAL; Division of Cardiology, Department of Medicine, Heart Rhythm Center, Taipei Veterans General Hospital, Taipei City, Taiwan.
  • Lin CY; Section of Clinical Cardiac Electrophysiology, Heart Institute, St. Luke's Medical Center - Global City, Taguig City, Philippines.
  • Lu CT; Division of Cardiology, Department of Medicine, Heart Rhythm Center, Taipei Veterans General Hospital, Taipei City, Taiwan.
  • Lo LW; Department of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.
  • Lin YJ; Division of Cardiology, Department of Medicine, Heart Rhythm Center, Taipei Veterans General Hospital, Taipei City, Taiwan.
  • Chang SL; Division of Cardiology, Department of Medicine, Heart Rhythm Center, Taipei Veterans General Hospital, Taipei City, Taiwan.
  • Hu YF; Department of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.
  • Chung FP; Division of Cardiology, Department of Medicine, Heart Rhythm Center, Taipei Veterans General Hospital, Taipei City, Taiwan.
  • Tuan TC; Department of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.
  • Chao TF; Division of Cardiology, Department of Medicine, Heart Rhythm Center, Taipei Veterans General Hospital, Taipei City, Taiwan.
  • Liao JN; Department of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.
  • Chang TY; Division of Cardiology, Department of Medicine, Heart Rhythm Center, Taipei Veterans General Hospital, Taipei City, Taiwan.
  • Kuo L; Department of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.
  • Liu CM; Division of Cardiology, Department of Medicine, Heart Rhythm Center, Taipei Veterans General Hospital, Taipei City, Taiwan.
  • Liu SH; Department of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.
  • Wu CI; Division of Cardiology, Department of Medicine, Heart Rhythm Center, Taipei Veterans General Hospital, Taipei City, Taiwan.
  • Kuo MJ; Department of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.
  • Li GY; Division of Cardiology, Department of Medicine, Heart Rhythm Center, Taipei Veterans General Hospital, Taipei City, Taiwan.
  • Huang YS; Department of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.
  • Wu SJ; Division of Cardiology, Department of Medicine, Heart Rhythm Center, Taipei Veterans General Hospital, Taipei City, Taiwan.
  • Siow YK; Department of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.
  • Son NND; Division of Cardiology, Department of Medicine, Heart Rhythm Center, Taipei Veterans General Hospital, Taipei City, Taiwan.
  • Tran DC; Department of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.
  • Chen SA; Division of Cardiology, Department of Medicine, Heart Rhythm Center, Taipei Veterans General Hospital, Taipei City, Taiwan.
Front Cardiovasc Med ; 10: 1265890, 2023.
Article in En | MEDLINE | ID: mdl-37953760
Background: Atrial fibrillation (AF) and mitral regurgitation (MR) have a complex interplay. Catheter ablation (CA) of AF may be a potential method to improve the severity of MR in AF patients. Methods: Patients with symptomatic AF and moderate to severe MR who underwent catheter ablation from 2011 to 2021 were retrospectively included in the study. Patients' baseline characteristics and electrophysiological features were examined. These patients were classified as group 1 with improved MR and group 2 with refractory MR after CA. Results: Fifty patients (age 60.2 ± 11.6 years, 29 males) were included in the study (32 in group 1 and 18 in group 2). Group 1 patients had a lower CHA2DS2-VASc score (1.7 ± 1.5 vs. 2.7 ± 1.5, P = 0.005) and had a lower incidence of hypertension (28.1% vs. 66.7%, P = 0.007) and diabetes mellitus (3.1% vs. 22.2%, P = 0.031) as compared to group 2 patients. Electroanatomic three-dimensional (3D) mapping showed that group 1 patients demonstrated less scars on the posterior bottom of the left atrium compared to group 2 patients (12.5% vs. 66.7%, P < 0.001). AF recurrence was not different between the two groups. After multivariate logistic regression analysis, a posterior bottom scar in the left atrium independently predicted refractory MR despite successful AF ablation. Conclusion: Most patients with AF and MR showed improvement of MR after AF ablation. A scar involving the posterior bottom of the left atrium is associated with poor recovery of MR.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Front Cardiovasc Med Year: 2023 Document type: Article Affiliation country: Taiwan Country of publication: Switzerland

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Front Cardiovasc Med Year: 2023 Document type: Article Affiliation country: Taiwan Country of publication: Switzerland