Masateru Takigawa1,2,3, Taishi Kuwahara4, Atsushi Takahashi4, Kenji Okubo4, Emiko Nakashima4, Yuji Watari4, Kazuya Yamao4, Jun Nakajima4, Yasuaki Tanaka4, Katsumasa Takagi4, Shigeki Kimura4, Hiroyuki Hikita4, Kenzo Hirao5, Mitsuaki Isobe6. 1. Cardiovascular Centre, Yokosuka Kyosai Hospital, 1-16 Yonegahama-Street, Yokosuka, 238-8558, Japan. teru.takigawa@gmail.com. 2. Heart Rhythm Centre, Tokyo Medical and Dental University, Tokyo, Japan. teru.takigawa@gmail.com. 3. Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan. teru.takigawa@gmail.com. 4. Cardiovascular Centre, Yokosuka Kyosai Hospital, 1-16 Yonegahama-Street, Yokosuka, 238-8558, Japan. 5. Heart Rhythm Centre, Tokyo Medical and Dental University, Tokyo, Japan. 6. Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
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.
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 AFpatients 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.
Authors: Zachary M Gertz; Amresh Raina; Stavros E Mountantonakis; Erica S Zado; David J Callans; Francis E Marchlinski; Martin G Keane; Frank E Silvestry Journal: Europace Date: 2011-04-13 Impact factor: 5.214
Authors: Hugh Calkins; Josep Brugada; Douglas L Packer; Riccardo Cappato; Shih-Ann Chen; Harry J G Crijns; Ralph J Damiano; D Wyn Davies; David E Haines; Michel Haissaguerre; Yoshito Iesaka; Warren Jackman; Pierre Jais; Hans Kottkamp; Karl Heinz Kuck; Bruce D Lindsay; Francis E Marchlinski; Patrick M McCarthy; J Lluis Mont; Fred Morady; Koonlawee Nademanee; Andrea Natale; Carlo Pappone; Eric Prystowsky; Antonio Raviele; Jeremy N Ruskin; Richard J Shemin Journal: Heart Rhythm Date: 2007-04-30 Impact factor: 6.343
Authors: Jinmiao Chen; Yulin Wang; Minzhi Lv; Zhaohua Yang; Shijie Zhu; Lai Wei; Tao Hong; Wenjun Ding; Yi Lin; Chunsheng Wang Journal: Ann Transl Med Date: 2020-11