Association Between Left and Right Atrial Remodeling With Atrial Fibrillation Recurrence After Pulmonary Vein Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation

Akutsu, Yasushi; Kaneko, Kyouichi; Kodama, Yukinobu; Suyama, Jumpei; Li, Huiling; Hamazaki, Yoko; Tanno, Kaoru; Gokan, Takehiko; Kobayashi, Youichi

doi:10.1161/circimaging.110.962761

Cited by 57 publications

(53 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The univariate and multivariate analyses found that LA diameter and a PM for AVB were associated with recurrence of AF. This finding also supports the results of previous studies [23][24][25] showing that the LA size is a well-known predictor of recurrence of AF after catheter ablation. Several mechanisms may account for the relationship between a PM for AVB and recurrence of AF.…”

Section: Discussionsupporting

confidence: 92%

“…20) RA remodeling is associated with AF recurrence. 25) Fourth, AVB may also contribute to recurrence of AF in the patients with a PM for AVB. Chronic AVB and the resulting slow idioventricular rhythm in a goat can lead to progressive atrial dilatation.…”

Section: Discussionmentioning

confidence: 99%

“…29) Atrial dilatation is a predictor of recurrence of AF after catheter ablation. [23][24][25] However, because the slow idioventricular rhythm is prevented effectively by PM therapy in these patients, the effect of AVB on recurrence of AF need further studies.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of Catheter Ablation for Atrial Fibrillation in Patients With a Permanent Pacemaker for Atrioventricular Block

Dong

Wang

et al. 2014

Int. Heart J.

View full text Add to dashboard Cite

SummaryCatheter ablation has been established to be an effective therapy for drug-refractory paroxysmal AF and is recommended as the treatment of choice for many patients, including those with a permanent pacemaker (PM). However, the clinical efficacy of catheter ablation of paroxysmal AF in patients with a permanent PM for atrioventricular block (AVB) is not clear. Twenty-nine patients with a permanent PM for AVB (AVB + PM group), and 145 age-and gender-matched control patients (on a 1:5 basis) without AVB and without a permanent PM (no-AVB + no-PM group), were included in this study. Atrial fibrillation (AF) recurrence was defined as the occurrence of confirmed atrial tachyarrhythmia lasting more than 30 seconds beyond 3 months after catheter ablation in the absence of any antiarrhythmic treatment. During a mean follow-up period of 14.2 ± 8.6 months (range, 3-30 months), 54 patients (31.0%) developed recurrence of AF. The recurrence rate was higher in the AVB + PM group than in the no-AVB + no-PM group (48.3% versus 27.6%, P = 0.005). Cox regression analysis with adjustment for age, valvular heart disease, AVB and a PM together, left atrial (LA) diameter and PV isolation identified LA diameter (hazard ratio 1.054, 95% confidence interval 1.001-1.110, P = 0.047) and AVB and a PM together (hazard ratio 2.095, 95% confidence interval 1.109-3.960, P = 0.023) as two independent predictors of recurrence of AF. Patients with a permanent PM for AVB were at an increased risk of recurrence of AF after catheter ablation. (Int Heart J 2014; 55: 489-493) Key words: Recurrence A trial fibrillation (AF) is a common cardiac arrhythmia in the general population 1) and is associated with increased cardiovascular morbidity and mortality.2,3) A recent study showed that AF is the most frequent tachyarrhythmia in patients with a permanent pacemaker (PM), occurring in up to 37% of patients implanted due to atrioventricular block (AVB).4) Catheter ablation has been established to be an effective therapy for drug-refractory paroxysmal AF and is recommended as the treatment of choice for many patients, including those with a permanent PM. However, there is still a risk of recurrence after ablation. Our previous study evaluated the clinical efficacy of catheter ablation of paroxysmal AF in patients with a permanent PM for sick sinus syndrome (SSS) and showed that SSS and the use of a pacemaker together was an independent predictor of recurrence of AF. 5) SSS is primarily a disease of the elderly and is presumed to be due to senescence of the sinus node and atrial muscle. 6) Thus, SSS likely reflects an underlying atrial disease, which may be associated with an increased rate of recurrence of AF. In AVB patients with a permanent PM, although AVB may contribute little to the development of AF recurrence, the cumulative percentages of ventricular pacing may be higher in AVB patients than in SSS patients. Whether these patients also have an increased risk of recurrence of AF after catheter ablation is not clear. This retrospective study ...

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of Catheter Ablation for Atrial Fibrillation in Patients With a Permanent Pacemaker for Atrioventricular Block

Dong

Wang

et al. 2014

Int. Heart J.

View full text Add to dashboard Cite

show abstract

“…First, the prolonged PR interval probably refl ects underlying atrial disease with atrial fi brosis or atrial dilatation. Atrial fi brosis [19][20][21] and atrial dilatation [22][23][24] are associated with increased recurrence of AF after catheter ablation. Second, a prolonged PR interval results in increased LA pressure, delayed and ineffective mitral valve closure, and diastolic mitral regurgitation.…”

Section: Discussionmentioning

confidence: 99%

“…25) The LA size is a well-known predictor of recurrence after catheter ablation for AF. [22][23][24] In addition, mechanoelectric feedback 26) and proliferation of arrhythmogenic fibroblasts 27,28) secondary to increased LA pressure may also play a role in promoting recurrence of AF. Third, a prolonged PR interval is associated with endothelial dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Prolonged PR Interval and Risk of Recurrence of Atrial Fibrillation After Catheter Ablation

Dong

Sang

et al. 2014

Int. Heart J.

View full text Add to dashboard Cite

SummaryIt has been demonstrated that a prolonged PR interval is associated with an increased risk of AF. However, the impact of a prolonged PR interval on recurrence of paroxysmal atrial fi brillation (AF) after catheter ablation is not clear. A total of 112 patients with a prolonged PR interval (PR > 200 ms) (PPR group) and 112 age-and gender-matched control patients (on a 1:1 basis) with a normal PR interval (NPR group) were included in this study. AF recurrence was defi ned as the occurrence of confi rmed atrial tachyarrhythmia lasting more than 30 seconds beyond 3 months after catheter ablation in the absence of any antiarrhythmic treatment. During a mean follow-up period of 10.9 ± 5.5 months (range, 3-18 months), 61 patients (27.2%) developed recurrence of AF. The recurrence rate was higher in the PPR group than in the NPR group (33.9% versus 20.5%, respectively; P = 0.018). Cox regression analysis with adjustment for age, body mass index, valvular heart disease, left atrial diameter, and pulmonary vein isolation identifi ed only a prolonged PR interval as an independent predictor of recurrence of AF (hazard ratio, 1.81; 95% confi dence interval, 1.07-3.05; P = 0.027). Patients with a prolonged PR interval were at an increased risk of AF recurrence after catheter ablation. (Int Heart J 2014; 55: 126-130) Key words: Atrial tachyarrhythmia A trial fi brillation (AF) is a common cardiac arrhythmia in the general population 1) and is associated with increased cardiovascular morbidity and mortality.2,3) A recent post hoc analysis of a Danish multicenter randomized trial (DANPACE trial) showed that a prolonged PR interval is associated with an increased risk of AF in patients with sick sinus syndrome.4) These results are in accordance with the fi ndings of a large community-based cohort study in which a PR interval longer than 200 ms was associated with a doubled risk of later AF compared with a shorter PR interval.5) Catheter ablation has been established as an effective therapy for drug-refractory paroxysmal AF. However, there is still a risk of recurrence after ablation. Previous studies have examined some predictors of AF recurrence. 6,7) However, there is little information available about the impact of a prolonged PR interval on recurrence of AF after catheter ablation. In patients with a prolonged PR interval, most of the pathogenic factors for AF persist after ablation. Therefore, it is reasonable to hypothesize that a prolonged PR interval increases the risk of recurrence of AF. This retrospective study evaluated the impact of a prolonged PR interval on recurrence of AF after catheter ablation. MethodsStudy subjects: We reviewed the records of 1593 consecutive patients with refractory symptomatic paroxysmal AF who had been prospectively entered into our database. All of these patients were referred to Beijing An Zhen Hospital, Capital Medical University for first-time circumferential pulmonary vein (PV) radiofrequency ablation from January 2008 to December 2012. The PR interval was considered to be p...

show abstract

Right atrial function by speckle tracking echocardiography in atrial septal defect: Prediction of atrial fibrillation

Vitarelli

Madon

Gaudio

et al. 2018

Clinical Cardiology

View full text Add to dashboard Cite

show abstract

Association Between Left and Right Atrial Remodeling With Atrial Fibrillation Recurrence After Pulmonary Vein Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation

Cited by 57 publications

References 34 publications

Efficacy of Catheter Ablation for Atrial Fibrillation in Patients With a Permanent Pacemaker for Atrioventricular Block

Efficacy of Catheter Ablation for Atrial Fibrillation in Patients With a Permanent Pacemaker for Atrioventricular Block

Prolonged PR Interval and Risk of Recurrence of Atrial Fibrillation After Catheter Ablation

Right atrial function by speckle tracking echocardiography in atrial septal defect: Prediction of atrial fibrillation

Contact Info

Product

Resources

About