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Risk Factors for Stiff Left Atrial Physiology 1 Year After Catheter Ablation of Atrial Fibrillation

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dc.contributor.author권오석-
dc.contributor.author김태훈-
dc.contributor.author박희남-
dc.contributor.author엄재선-
dc.contributor.author유희태-
dc.contributor.author이문형-
dc.contributor.author정보영-
dc.contributor.author이재혁-
dc.contributor.author권오석-
dc.date.accessioned2021-12-28T17:18:39Z-
dc.date.available2021-12-28T17:18:39Z-
dc.date.issued2021-09-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/187039-
dc.description.abstractCatheter ablation is the most effective rhythm control method for patients with atrial fibrillation (AF); however, it inevitably causes atrial tissue damage. We previously reported that AF catheter ablation (AFCA) increases left atrial (LA) pressure without changes in symptom scores. We hypothesized that extensive LA ablation increased the risk of stiff LA physiology. We included 1,720 patients (69.1% male, 60.0 [53.0-68.0] years old, 66.2% with paroxysmal AF) who underwent de novo AFCA and echocardiography before and 1-year after the procedure. Stiff LA physiology was defined, when the amount of the estimated pulmonary arterial pressure increase between the pre-procedural and the 1-year post-procedural follow-up echocardiography was >10 mmHg and when right ventricular systolic pressure (RVSP) was >35 mmHg at 1-year follow-up echocardiography. The failed rhythm control within 1 year was defined as recurrent AF despite using anti-arrhythmic drugs or cardioversion within a year of AFCA. We explored the incidence and risk factors for stiff LA physiology and the rhythm outcome of AFCA. Among the 1,720 patients, 64 (3.7%) had stiff LA physiology 1 year after AFCA. Stiff LA physiology was independently associated with diabetes (odds ratio [OR], 2.36 [95% CI, 1.14-4.87], p = 0.020), the ratio of the peak mitral flow velocity of the early rapid filling to the early diastolic velocity of the mitral annulus (E/Em; OR, 1.04 [95% CI, 1.00-1.10], p = 0.049), LA pulse pressure (Model 2: OR, 1.05 [95% CI, 1.00-1.11], p = 0.049), low LA voltage (OR, 0.36 [95% CI, 0.18-0.74], p = 0.005), empirical extra-pulmonary vein (PV) LA ablation (OR, 2.60 [95% CI, 1.17-5.74], p = 0.018), and radiofrequency (RF) ablation duration (Model 2: OR, 1.02 [95% CI, 1.01-1.03], p = 0.003). Although the incidence of post-AFCA stiff LA physiology was 3.7% and most of the cases were subclinical, the empirical extra-PV ablation was associated with this undesirable condition. In addition, patients who had low mean LA voltage before AFCA could be susceptible to stiff LA physiology.-
dc.description.statementOfResponsibilityopen-
dc.formatapplication/pdf-
dc.languageEnglish-
dc.publisherFrontiers Research Foundation-
dc.relation.isPartOfFRONTIERS IN PHYSIOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.titleRisk Factors for Stiff Left Atrial Physiology 1 Year After Catheter Ablation of Atrial Fibrillation-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentBioMedical Science Institute (의생명과학부)-
dc.contributor.googleauthorJae-Hyuk Lee-
dc.contributor.googleauthorOh-Seok Kwon-
dc.contributor.googleauthorHee Tae Yu-
dc.contributor.googleauthorTae-Hoon Kim-
dc.contributor.googleauthorJae-Sun Uhm-
dc.contributor.googleauthorBoyoung Joung-
dc.contributor.googleauthorMoon-Hyoung Lee-
dc.contributor.googleauthorHui-Nam Pak-
dc.identifier.doi10.3389/fphys.2021.740600-
dc.contributor.localIdA06119-
dc.contributor.localIdA01085-
dc.contributor.localIdA01776-
dc.contributor.localIdA02337-
dc.contributor.localIdA02535-
dc.contributor.localIdA02766-
dc.contributor.localIdA03084-
dc.contributor.localIdA03609-
dc.relation.journalcodeJ02868-
dc.identifier.eissn1664-042X-
dc.identifier.pmid34616311-
dc.subject.keywordatrial fibrillation-
dc.subject.keywordcatheter ablation-
dc.subject.keywordextensive ablation-
dc.subject.keywordrhythm outcome-
dc.subject.keywordstiff left atrium-
dc.contributor.alternativeNameKwon, Oh-Seok-
dc.contributor.affiliatedAuthor권오석-
dc.contributor.affiliatedAuthor김태훈-
dc.contributor.affiliatedAuthor박희남-
dc.contributor.affiliatedAuthor엄재선-
dc.contributor.affiliatedAuthor유희태-
dc.contributor.affiliatedAuthor이문형-
dc.contributor.affiliatedAuthor정보영-
dc.citation.volume12-
dc.citation.startPage740600-
dc.identifier.bibliographicCitationFRONTIERS IN PHYSIOLOGY, Vol.12 : 740600, 2021-09-
Appears in Collections:
1. College of Medicine (의과대학) > BioMedical Science Institute (의생명과학부) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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