Association between functional mitral regurgitation and recurrence of paroxysmal atrial fibrillation following catheter ablation: a prospective cohort study

Abstract

Objective The present study aimed to investigate the effect of functional mitral regurgitation (FMR) on recurrence of paroxysmal atrial fibrillation (PAF) in patients undergoing radiofrequency catheter ablation. Methods This prospective cohort study comprised 107 patients with PAF. The patients were divided into the FMR and non-FMR groups. FMR was assessed by Doppler echocardiography before index ablation. All patients initially underwent circumferential pulmonary vein isolation (CPVI) and were followed up for 12 months after ablation. PAF, atrial tachycardia, or atrial flutter served as the endpoint indicator. Results The median duration of PAF was 24 (3–60) months. Binary logistic univariate and multivariate analyses showed that FMR was not a risk factor for recurrence of catheter ablation for PAF (hazard ratio=0.758, 95% confidence interval: 0.191–3.004; hazard ratio=0.665, 95% confidence interval: 0.134–3.300, respectively). Kaplan–Meier analysis showed no significant difference in the recurrence rate between the groups. Fifteen (15/107, 14%) cases of PAF were triggered by the pulmonary vein. Three (3/107, 2.8%) cases of PAF were triggered by the superior vena cava. Conclusions FMR is not an independent risk factor for predicting recurrence of catheter ablation for PAF. FMR does not affect patients undergoing radiofrequency catheter ablation for PAF.

Long-Term Clinical Outcomes Following Cryoballoon Ablation in Patients with Paroxysmal Atrial Fibrillation: Single-Center Experience

“…[31] On the contrary, in a smaller-scale study, MR was not found to be an independent determinant of post-ablation AF recurrence in patients undergoing catheter ablation for PAF. [32] In our study, similarly, higher degrees of MR were observed in the group experiencing recurrence, but it was not identified as an independent variable in Cox regression analysis. This finding is consistent with the study conducted by Ke et al, [32] which initially appeared to have similar high MR degrees.…”

“…[32] In our study, similarly, higher degrees of MR were observed in the group experiencing recurrence, but it was not identified as an independent variable in Cox regression analysis. This finding is consistent with the study conducted by Ke et al, [32] which initially appeared to have similar high MR degrees.…”

Efficacy of catheter ablation for atrial fibrillation in patients with significant functional mitral regurgitation

“…[15] Conflicting data on the association between functional MR and the risk of AF recurrence post-ablation were reported in these 2 studies. Furthermore, both of these studies included patients who mainly had mild functional MR, and only 5% (2/40) [14] and 9% (6/66) [15] of patients had significant functional MR.…”

“…[14] In contrast, a recent study conducted by Ke and colleagues showed that functional MR was not an independent risk factor for predicting the recurrence of catheter ablation for paroxysmal AF. [15] Conflicting data on the association between functional MR and the risk of AF recurrence post-ablation were reported in these 2 studies. Furthermore, both of these studies included patients who mainly had mild functional MR, and Patients with significant functional MR had a higher rate of recurrence of atrial tachyarrhythmia than those without significant functional MR (42.9% vs 15.1%, P < .001 by the log-rank test).…”