The mechanism of mitral regurgitation assessed by preprocedural echocardiography is associated with the outcome of catheter ablation in patients with paroxysmal atrial fibrillation.
J Interv Card Electrophysiol
; 46(3): 299-306, 2016 Sep.
Article
en En
| MEDLINE
| ID: mdl-26979839
ABSTRACT
BACKGROUND:
Mitral regurgitation (MR) is generally classified as either primary (organic) or secondary (functional). Although patients with atrial fibrillation (AF) often exhibit MR, the relation between the etiology of MR and the outcome of catheter ablation (CA) remains unknown. We conducted this study in order to elucidate this association.METHODS:
Among 1330 consecutive paroxysmal AF patients who underwent initial catheter ablation in our institution, 92 patients (62 men, mean age 65 ± 7 years) who had moderate or severe MR were included in this study; 46 were classified to have primary and the remaining 46 to have secondary MR by preoperative echocardiography. These patients were prospectively monitored after the CA.RESULTS:
During a mean follow-up period of 27.9 ± 28.8 months, AF recurred in 26/46 (56.6 %) of primary MR patients and in 15/46 (32.6 %) of those with secondary MR (P < 0.02). Although univariate analysis found that diabetes, left atrial volume indexed by body surface area (LAVI), and primary MR were significantly associated with AF recurrence, primary MR (hazard ratio (HR), 2.47; 95 % confidence interval (CI), 1.30-4.88; P = 0.006) and LAVI (HR, 1.03/1 mL/m(2) increase; 95 % CI, 1.00-1.06; P = 0.03) remained significant predictors on multivariate analysis. The AF recurrence-free rate was lower in patients with primary MR after both the initial and final CA.CONCLUSION:
In patients with paroxysmal AF and moderate or severe MR, primary MR may increase the risk of AF recurrence after the initial and final CA.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Fibrilación Atrial
/
Ecocardiografía
/
Ablación por Catéter
/
Insuficiencia de la Válvula Mitral
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
/
Male
País/Región como asunto:
Asia
Idioma:
En
Revista:
J Interv Card Electrophysiol
Asunto de la revista:
CARDIOLOGIA
Año:
2016
Tipo del documento:
Article
País de afiliación:
Japón