Improved Endothelial Function in Patients with Atrial Fibrillation through Maintenance of Sinus Rhythm by Successful Catheter Ablation

Shin, Seung Yong; Na, Jin Oh; Lim, Hong Euy; Choi, Cheol Ung; Choi, Jong Il; Kim, Seong Hwan; Kim, Eung Ju; Park, Sang Weon; Rha, Seung Woon; Park, Chang Gyu; Seo, Hong Seog; Oh, Dong Joo; Kim, Young-Hoon

doi:10.1111/j.1540-8167.2010.01919.x

Cited by 57 publications

(46 citation statements)

References 34 publications

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“…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: 82%

“…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%

“…28) Endothelial dysfunction is an important predictor of recurrence of AF after catheter ablation. 23) Third, RV lead induced TR. TR resulted in increased RA pressure and subsequent RA remodeling.…”

Section: Discussionmentioning

confidence: 99%

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

Dong

Wang

et al. 2014

Int. Heart J.

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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 ...

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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

Dong

Wang

et al. 2014

Int. Heart J.

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“…Shin et al reported that catheter ablation for AF patients with no recurrence improved endothelial dysfunction by the measurement of flow-mediated dilation (FMD), but they needed for 6 months to the FMD score of control subject. 51 Furthermore, the patients with recurrence continue endothelial dysfunction after AF ablation. 51 However, some reports showed that HMG-CoA reductase inhibitors and omega-3 fatty acids had protective effectives for AF patients post-cardioversion or ablation.…”

Section: Discussionmentioning

confidence: 99%

“…51 Furthermore, the patients with recurrence continue endothelial dysfunction after AF ablation. 51 However, some reports showed that HMG-CoA reductase inhibitors and omega-3 fatty acids had protective effectives for AF patients post-cardioversion or ablation. 52, 53 We thought that the animal model without AF we used in this study is similar to that of patients post-cardioversion or ablation, and some continuous anticoagulant therapies or treatment for endothelial dysfunction might be beneficial in these patients without an AF condition.…”

Section: Discussionmentioning

confidence: 99%

Enhancement of Endothelial Function Inhibits Left Atrial Thrombi Development in an Animal Model of Spontaneous Left Atrial Thrombosis

Mawatari

Yoshioka

Toda

et al. 2014

Circ J

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Influence of Body Mass Index on Recurrence and Quality of Life in Atrial Fibrillation Patients After Catheter Ablation: A Meta‐Analysis and Systematic Review

Zhuang

Tang

et al. 2013

Clinical Cardiology

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Background: Accumulating evidence has demonstrated that overweight and obesity, expressed as high body mass index (BMI), are associated with the development of atrial fibrillation (AF) and quality of life (QoL) in AF patients. However, the role of high BMI as a risk factor for prognosis and QoL in AF patients undergoing ablation remains controversial. Hypothesis: We hypothesized that elevated BMI was correlated with AF recurrence and QoL after an ablative procedure.Methods: We performed a comprehensive search of PubMed, EMBASE, and the Cochrane Library. Studies were included if they investigated the association of BMI with AF recurrence and QoL after ablation. Results: Of the 151 articles identified, 12 studies that enrolled 3286 individuals met the inclusion criteria. Overall, compared with normal-BMI patients, AF recurrence occured more frequently in high-BMI patients after ablation (odds ratio: 1.32, 95% confidence interval: 1.17-1.5, P < 0.001). However, the pooled esimate of odds ratio adjusted for multiple confounders did not reach significance. The summary weighted mean difference of BMI between patients with and without recurrence was 0.43 (95% confidence interval: 0.05-0.81, P = 0.027). In addition, QoL scores were significantly lower in high-BMI than in normal-BMI patients before the ablative procedure, whereas the gap of QoL between normal-BMI and high-BMI groups was decreased at follow-up. Conclusions: Results of this meta-analysis suggest 2 points, namely that the tight association between overweight/obesity and AF recurrence after ablation may be partly due to other concomitant conditions, and that impaired QoL in high-BMI groups is significantly improved after ablation.

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Improved Endothelial Function in Patients with Atrial Fibrillation through Maintenance of Sinus Rhythm by Successful Catheter Ablation

Abstract: AF subjects have significantly impaired FMD, which can be reversed through maintenance of SR by successful CA. FMD(baseline), hs-CRP, and LAV are important predictors for AF recurrence after CA.

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

Enhancement of Endothelial Function Inhibits Left Atrial Thrombi Development in an Animal Model of Spontaneous Left Atrial Thrombosis

Influence of Body Mass Index on Recurrence and Quality of Life in Atrial Fibrillation Patients After Catheter Ablation: A Meta‐Analysis and Systematic Review

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