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Delayed recurrence of atrial fibrillation 2years after catheter ablation is associated with metabolic syndrome

Authors
 Yong-Soo Baek  ;  Pil-Sung Yang  ;  Tae-Hoon Kim  ;  Jae-Sun Uhm  ;  Jong-Youn Kim  ;  Boyoung Joung  ;  Moon-Hyoung Lee  ;  Hui-Nam Pak 
Citation
 INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol.223 : 276-281, 2016 
Journal Title
 INTERNATIONAL JOURNAL OF CARDIOLOGY 
ISSN
 0167-5273 
Issue Date
2016
MeSH
Aged ; Atrial Fibrillation/epidemiology* ; Atrial Fibrillation/physiopathology ; Atrial Fibrillation/surgery* ; Catheter Ablation/trends* ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Metabolic Syndrome/epidemiology* ; Metabolic Syndrome/physiopathology ; Middle Aged ; Overweight/epidemiology ; Overweight/physiopathology ; Polysomnography/trends ; Recurrence ; Retrospective Studies ; Risk Factors ; Sleep Apnea, Obstructive/epidemiology ; Sleep Apnea, Obstructive/physiopathology ; Time Factors ; Treatment Outcome
Keywords
Atrial fibrillation ; Catheter ablation ; Overweight ; Progression ; Recurrence
Abstract
BACKGROUND: Whether delayed clinical recurrence of atrial fibrillation (AF) 2years after radiofrequency catheter ablation (CR>2-years) is related to AF progression remains unclear. OBJECTIVE: We hypothesized that metabolic factors are associated with CL>2-years. METHODS: Among 1825 patients who underwent catheter ablation, the study included 523 patients with AF recurrence (27.2% women, mean age 57±11years, 58.3% paroxysmal AF) 3months after the ablation procedure. They were divided into the clinical recurrence within 2-years (CL≤2-years: AF recurrence at 3-24months) and CL>2-years (AF recurrence >24months) groups. Clinical and imaging parameters and polysomnograms were compared. RESULTS: Over 42±19months of follow-up, 409 (78.2%) and 114 (21.8%) patients formed the CL≤2-years and CL>2-years groups, respectively. The CL>2-years group had higher proportions of overweight (p=0.004), hypertension (p=0.049), diabetes mellitus (p=0.037), dyslipidemia (p=0.009), high sensitivity C-reactive protein >8mg/L (p=0.049), and metabolic syndrome (p=0.011) than the CL≤2-years group. Despite no significant difference between the apnea and hypopnea indices in the CL≤2-years (n=97) and CL>2-years (n=28) groups, the minimum peripheral oxygen saturation was significantly lower in the latter than the former (p=0.032). In the multivariate analysis, overweight (odds ratio [OR] 1.756, 95% confidence interval [CI] 1.146-2.693, p=0.010), dyslipidemia (OR 1.587, 95% CI 1.033-2.438, p=0.035), and metabolic syndrome (OR 1.972, 95% CI 1.158-3.356, p=0.012) were independently associated with CL>2-years. CONCLUSIONS: Overweight, dyslipidemia, and metabolic syndrome are independent predictors of CL>2-years for AF after catheter ablation. CL>2-years seems to be affected by metabolic factors and can be related to AF progression.
Full Text
http://www.sciencedirect.com/science/article/pii/S0167527316319295?via%3Dihub
DOI
10.1016/j.ijcard.2016.08.222
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jong Youn(김종윤) ORCID logo https://orcid.org/0000-0001-7040-8771
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Yang, Pil Sung(양필성)
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Lee, Moon Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152520
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