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Atrial Fibrillation Catheter Ablation Increases the Left Atrial Pressure

Authors
 Je-Wook Park  ;  Hee Tae Yu  ;  Tae-Hoon Kim  ;  Jae-Sun Uhm  ;  Boyoung Joung  ;  Moon-Hyoung Lee  ;  Chun Hwang  ;  Hui-Nam Pak 
Citation
 CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, Vol.12(4) : e007073, 2019 
Journal Title
 CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY 
ISSN
 1941-3149 
Issue Date
2019
Keywords
atrial fibrillation ; catheter ablation ; heart atria ; pressure
Abstract
BACKGROUND: We previously reported that a high left atrial (LA) pressure is associated with LA stiffness and poor rhythm outcomes after de novo catheter ablation of atrial fibrillation. Herein, we investigated whether radiofrequency catheter ablation generally changes the LA pressure among patients undergoing repeat procedures. METHODS: Among 1848 patients who underwent atrial fibrillation catheter ablation, we measured the LA pressure during sinus rhythm in 1687 patients before the de novo ablation (59±11 years, 72.4% men, 72.8% paroxysmal atrial fibrillation) and in 142 with second procedures. We measured the LA pressure immediately after the transseptal puncture at the beginning of the procedure. RESULTS: In the same 142 patients, the degree of LA stiffness, reflected by the LA pulse pressure (LApp), was significantly higher in the second procedure than in the de novo procedure ( P<0.001). The degree of the LApp increase (ΔLApp) was significantly higher in patients who underwent additional extrapulmonary vein LA ablation than in those who underwent circumferential pulmonary vein isolation alone ( P=0.010). Extrapulmonary vein LA ablation was independently associated with the ΔLApp (β=5.70 [0.12-11.27]; P=0.045). An increased LApp during repeat procedures was independently associated with a reduced diastolic function (β=2.01 [0.08-3.93]; P=0.041) without a worsening symptoms (EuroQol-five dimensions) score, 22.2±17.9 months after the de novo ablation. CONCLUSIONS: Atrial fibrillation catheter ablation, especially extrapulmonary vein LA ablation, increased the LA stiffness and was associated with a worsening postablation diastolic function. However, the symptom score did not significantly change. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02138695.
Full Text
https://www.ahajournals.org/doi/full/10.1161/CIRCEP.118.007073
DOI
10.1161/CIRCEP.118.007073
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Park, Je Wook(박제욱)
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Yu, Hee Tae(유희태) ORCID logo https://orcid.org/0000-0002-6835-4759
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/22282913/169975
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