Left atrial functional reservoir

predictive value for outcome of catheter ablation in paroxysmal atrial fibrillation

Hwan Cheol Park, Yonggu Lee, Dae In Lee, Yae Min Park, Jaemin Shim, Ji Eun Ban, Jongil Choi, Sang Weon Park, Young Hoon Kim

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Left arial (LA) function, defined according to conduit, reservoir and booster functions, is closely linked to left ventricular (LV) mechanics, particularly during diastole. Right ventricular pacing (RVP) is thought to impair LA diastolic restoring forces through alteration of ventricular activation. The aim of this study was to determine whether the LA functional reservoir estimated as the change in mean LA ejection fraction (EF) immediately after RVP, and for the second and for the third beats after RVP, predicts clinical outcome in patients with paroxysmal atrial fibrillation (AF) who have undergone catheter ablation (CA). Data from 155 patients with paroxysmal AF (56.0 ± 10.6 years, M:F = 114:41) were analyzed. All patients underwent LA angiography during RVP. LA EFs were measured at the immediate first (LA EF1), second (LA EF2) and third beats (LA EF3) after RVP, using a right anterior oblique 30° view. During follow-up, AF recurred in 35 patients (22.6 %). Mean LA EF1 was 37.9 ± .8 % in the AF recurrence group and 48.0 ± 8.6 % in the non-recurrence group (P < 0.001). Mean LA EF2 and LA EF3 were also lower in the AF recurrence group than in the non-recurrence group (P < 0.001, respectively). Mean percent changes from LA EF2 to LA EF3 were −0.4 ± 3.4 in the AF recurrence group and 5.2 ± 4.9 in the non-recurrence group (P = 0.041). The change in mean EF from LA EF1 to LA EF3 in the non-recurrence group was significantly greater than in the recurrence group (P = 0.001). Cox regression analysis showed that predictors of AF recurrence were LA EF2, LA EF3 and accompanied obstructive sleep apnea (OSA) (P < 0.001, respectively). Decreased functional LA reservoir (LA EF after RVP) and OSA are significantly related to recurrence of AF following CA in patients with paroxysmal AF.

Original languageEnglish
Pages (from-to)1423-1434
Number of pages12
JournalInternational Journal of Cardiovascular Imaging
Volume30
Issue number8
DOIs
Publication statusPublished - 2014 Jan 1

Fingerprint

Catheter Ablation
Atrial Fibrillation
Recurrence
Obstructive Sleep Apnea
Diastole
Mechanics
Angiography
Regression Analysis

Keywords

  • Catheter ablation
  • Functional reservoir
  • Left atrium
  • Obstructive sleep apnea
  • Right ventricular pacing

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Left atrial functional reservoir : predictive value for outcome of catheter ablation in paroxysmal atrial fibrillation. / Park, Hwan Cheol; Lee, Yonggu; Lee, Dae In; Park, Yae Min; Shim, Jaemin; Ban, Ji Eun; Choi, Jongil; Park, Sang Weon; Kim, Young Hoon.

In: International Journal of Cardiovascular Imaging, Vol. 30, No. 8, 01.01.2014, p. 1423-1434.

Research output: Contribution to journalArticle

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abstract = "Left arial (LA) function, defined according to conduit, reservoir and booster functions, is closely linked to left ventricular (LV) mechanics, particularly during diastole. Right ventricular pacing (RVP) is thought to impair LA diastolic restoring forces through alteration of ventricular activation. The aim of this study was to determine whether the LA functional reservoir estimated as the change in mean LA ejection fraction (EF) immediately after RVP, and for the second and for the third beats after RVP, predicts clinical outcome in patients with paroxysmal atrial fibrillation (AF) who have undergone catheter ablation (CA). Data from 155 patients with paroxysmal AF (56.0 ± 10.6 years, M:F = 114:41) were analyzed. All patients underwent LA angiography during RVP. LA EFs were measured at the immediate first (LA EF1), second (LA EF2) and third beats (LA EF3) after RVP, using a right anterior oblique 30° view. During follow-up, AF recurred in 35 patients (22.6 {\%}). Mean LA EF1 was 37.9 ± .8 {\%} in the AF recurrence group and 48.0 ± 8.6 {\%} in the non-recurrence group (P < 0.001). Mean LA EF2 and LA EF3 were also lower in the AF recurrence group than in the non-recurrence group (P < 0.001, respectively). Mean percent changes from LA EF2 to LA EF3 were −0.4 ± 3.4 in the AF recurrence group and 5.2 ± 4.9 in the non-recurrence group (P = 0.041). The change in mean EF from LA EF1 to LA EF3 in the non-recurrence group was significantly greater than in the recurrence group (P = 0.001). Cox regression analysis showed that predictors of AF recurrence were LA EF2, LA EF3 and accompanied obstructive sleep apnea (OSA) (P < 0.001, respectively). Decreased functional LA reservoir (LA EF after RVP) and OSA are significantly related to recurrence of AF following CA in patients with paroxysmal AF.",
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AU - Park, Hwan Cheol

AU - Lee, Yonggu

AU - Lee, Dae In

AU - Park, Yae Min

AU - Shim, Jaemin

AU - Ban, Ji Eun

AU - Choi, Jongil

AU - Park, Sang Weon

AU - Kim, Young Hoon

PY - 2014/1/1

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N2 - Left arial (LA) function, defined according to conduit, reservoir and booster functions, is closely linked to left ventricular (LV) mechanics, particularly during diastole. Right ventricular pacing (RVP) is thought to impair LA diastolic restoring forces through alteration of ventricular activation. The aim of this study was to determine whether the LA functional reservoir estimated as the change in mean LA ejection fraction (EF) immediately after RVP, and for the second and for the third beats after RVP, predicts clinical outcome in patients with paroxysmal atrial fibrillation (AF) who have undergone catheter ablation (CA). Data from 155 patients with paroxysmal AF (56.0 ± 10.6 years, M:F = 114:41) were analyzed. All patients underwent LA angiography during RVP. LA EFs were measured at the immediate first (LA EF1), second (LA EF2) and third beats (LA EF3) after RVP, using a right anterior oblique 30° view. During follow-up, AF recurred in 35 patients (22.6 %). Mean LA EF1 was 37.9 ± .8 % in the AF recurrence group and 48.0 ± 8.6 % in the non-recurrence group (P < 0.001). Mean LA EF2 and LA EF3 were also lower in the AF recurrence group than in the non-recurrence group (P < 0.001, respectively). Mean percent changes from LA EF2 to LA EF3 were −0.4 ± 3.4 in the AF recurrence group and 5.2 ± 4.9 in the non-recurrence group (P = 0.041). The change in mean EF from LA EF1 to LA EF3 in the non-recurrence group was significantly greater than in the recurrence group (P = 0.001). Cox regression analysis showed that predictors of AF recurrence were LA EF2, LA EF3 and accompanied obstructive sleep apnea (OSA) (P < 0.001, respectively). Decreased functional LA reservoir (LA EF after RVP) and OSA are significantly related to recurrence of AF following CA in patients with paroxysmal AF.

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