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One-Year Change in the H 2 FPEF Score After Catheter Ablation of Atrial Fibrillation in Patients With a Normal Left Ventricular Systolic Function

Authors
 Min Kim  ;  Hee Tae Yu  ;  Tae-Hoon Kim  ;  Jae-Sun Uhm  ;  Boyoung Joung  ;  Moon-Hyoung Lee  ;  Hui-Nam Pak 
Citation
 FRONTIERS IN CARDIOVASCULAR MEDICINE, Vol.8 : 699364, 2021-08 
Journal Title
FRONTIERS IN CARDIOVASCULAR MEDICINE
Issue Date
2021-08
Keywords
atrial fibrillation ; catheter ablation ; left venticular diastolic dysfunction ; recurrent event ; risk score
Abstract
Background: It is unclear whether atrial fibrillation (AF) catheter ablation (AFCA) improves the left ventricular (LV) diastolic function. We evaluated the 1-year change in the H2FPEF score, which reflects the degree of LV diastolic function, after AFCA among patients with a normal LV systolic function. Methods and Results: We included 1,471 patients (30.7% female, median age 60 years, paroxysmal-type AF 68.6%) who had available H2FPEF scores at baseline and at 1-year after AFCA to evaluate the 1-year change in the H2FPEF score (ΔH2FPEF score[1-yr]) after AFCA. Baseline high H2FPEF scores (≥6) were independently associated with the female sex, left atrium (LA) diameter, LV mass index, pericardial fat volume, and a low estimated glomerular filtration rate. One year after AFCA, decreased ΔH2FPEF scores[1-yr] were associated with baseline H2FPEF scores of ≥6 [OR, 4.19 (95% CI, 2.88-6.11), p < 0.001], no diabetes [OR, 0.60 (95% CI, 0.37-0.98), p = 0.04], and lower pericardial fat volume [OR, 0.99 (95% CI, 0.99-1.00), p = 0.003]. Increased ΔH2FPEF scores[1-yr] were associated with a baseline H2FPEF score of <6 [OR, 3.54 (95% CI, 2.08-6.04), p < 0.001] and sustained AF after a recurrence within 1 year [SustainAF[1-yr]; OR, 1.89 (95% CI, 1.01-3.54), p = 0.048]. Throughout a 56-month median follow-up, an increased ΔH2FPEF score[1-yr] resulted in a poorer rhythm outcome of AFCA (at 1 year, log-rank p = 0.003; long-term, log-rank p = 0.010). Conclusions: AFCA appears to improve LV diastolic dysfunction. However, SustainAF[1-yr] may contribute to worsening LV diastolic dysfunction, and it was shown by increased ΔH2FPEF scores[1-yr], which was independently associated with higher risk of AF recurrence rate after AFCA. Clinical Trial Registration:ClinicalTrials.gov Identifier: NCT02138695.
Files in This Item:
T202104113.pdf Download
DOI
10.3389/fcvm.2021.699364
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
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/22282913/185441
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