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High left atrial pressures are associated with advanced electroanatomical remodeling of left atrium and independent predictors for clinical recurrence of atrial fibrillation after catheter ablation

DC Field Value Language
dc.contributor.author박준범-
dc.contributor.author박희남-
dc.contributor.author심지영-
dc.contributor.author엄재선-
dc.contributor.author이문형-
dc.contributor.author정보영-
dc.date.accessioned2015-01-06T16:50:21Z-
dc.date.available2015-01-06T16:50:21Z-
dc.date.issued2014-
dc.identifier.issn1547-5271-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/98868-
dc.description.abstractBACKGROUND: The clinical significance of left atrial pressure (LAP) has not yet been clearly elucidated in patients with atrial fibrillation (AF). OBJECTIVE: To explore the effects of elevated LAP on pathophysiology and clinical outcome after radiofrequency catheter ablation in patients with AF. METHODS: We measured LAP during both sinus rhythm (SR) and AF in 454 patients 348 (76.7%) men; mean age 58 ± 11 years; 326(71.8%) paroxysmal AF) who underwent radiofrequency catheter ablation and compared LAP at v wave (LAPpeak) and LAP at y descent (LAPnadir) by using imaging (echocardiography and computed tomography), electrophysiologic mapping (NavX), and clinical data. In 280 (61.7%) patients, pulmonary vein (PV) diastolic flow velocity was measured during SR by transesophageal echocardiography. RESULTS: Patients with LAPpeak(SR) ≥19 mm Hg had greater left atrial (LA) dimension (P < .001), LA volume index (P = .003), and E/Em (mitral annular septal area [peak diastolic velocity]; P = .001) but reduced LA voltage (P < .001) and mitral annular septal area (peak systolic velocity; P = .006) compared with patients with LAPpeak(SR) <19 mm Hg. High LAPpeak(SR) was independently associated with anterior LA volume (linear regression coefficient [B] = 0.381; 95% confidence interval [CI] 0.169-0.593; P < .001) and low LA voltage (B = -0.022; 95% CI -0.030 to -0.013; P < .001). PV diastolic flow velocity (B = 0.161; 95% CI 0.083-0.239; P < .001) and E/Em (B = 0.430; 95% CI 0.096-0.763; P = .012) were independent, noninvasive parameters associated with high LApeak(SR). During 13.1 ± 6.0 months of follow-up, high LAPpeak(SR) was an independent predictor for clinical recurrence of AF (hazard ratio 1.887; 95% CI 1.063-3.350; P = .028). CONCLUSION: Elevated LAP was closely associated with electroanatomical remodeling of the LA and was an independent predictor for recurrence after AF ablation. PV diastolic flow velocity and E/Em can be used as a noninvasive parameter predicting high LAPpeak(SR) in patients with AF.-
dc.description.statementOfResponsibilityopen-
dc.format.extent953~960-
dc.relation.isPartOfHEART RHYTHM-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAged-
dc.subject.MESHAtrial Fibrillation/mortality-
dc.subject.MESHAtrial Fibrillation/physiopathology*-
dc.subject.MESHAtrial Fibrillation/therapy-
dc.subject.MESHAtrial Function, Left/physiology*-
dc.subject.MESHAtrial Pressure/physiology*-
dc.subject.MESHCatheter Ablation-
dc.subject.MESHElectrophysiologic Techniques, Cardiac-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHKaplan-Meier Estimate-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHRecurrence-
dc.titleHigh left atrial pressures are associated with advanced electroanatomical remodeling of left atrium and independent predictors for clinical recurrence of atrial fibrillation after catheter ablation-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학)-
dc.contributor.googleauthorJunbeom Park-
dc.contributor.googleauthorBoyoung Joung-
dc.contributor.googleauthorJae-Sun Uhm-
dc.contributor.googleauthorChi Young Shim-
dc.contributor.googleauthorChun Hwang-
dc.contributor.googleauthorMoon Hyoung Lee-
dc.contributor.googleauthorHui-Nam Pak-
dc.identifier.doi10.1016/j.hrthm.2014.03.009-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA01670-
dc.contributor.localIdA01776-
dc.contributor.localIdA02213-
dc.contributor.localIdA02337-
dc.contributor.localIdA02766-
dc.contributor.localIdA03609-
dc.relation.journalcodeJ00980-
dc.identifier.eissn1556-3871-
dc.identifier.pmid24607916-
dc.identifier.urlhttp://www.sciencedirect.com/science/article/pii/S1547527114002483-
dc.subject.keywordAtrial fibrillation-
dc.subject.keywordCatheter ablation-
dc.subject.keywordLeft atrial pressure-
dc.subject.keywordRecurrence-
dc.contributor.alternativeNamePark, Jun Beom-
dc.contributor.alternativeNamePak, Hui Nam-
dc.contributor.alternativeNameShim, Chi Young-
dc.contributor.alternativeNameUhm, Jae Sun-
dc.contributor.alternativeNameLee, Moon Hyoung-
dc.contributor.alternativeNameJoung, Bo Young-
dc.contributor.affiliatedAuthorPark, Jun Beom-
dc.contributor.affiliatedAuthorPak, Hui Nam-
dc.contributor.affiliatedAuthorShim, Chi Young-
dc.contributor.affiliatedAuthorUhm, Jae Sun-
dc.contributor.affiliatedAuthorLee, Moon Hyoung-
dc.contributor.affiliatedAuthorJoung, Bo Young-
dc.rights.accessRightsfree-
dc.citation.volume11-
dc.citation.number6-
dc.citation.startPage953-
dc.citation.endPage960-
dc.identifier.bibliographicCitationHEART RHYTHM, Vol.11(6) : 953-960, 2014-
dc.identifier.rimsid38836-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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