Resting and exercise-induced left atrial hypertension in patients with atrial fibrillation: The causes and implications for catheter ablation

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F17%3A00076328" target="_blank" >RIV/00023001:_____/17:00076328 - isvavai.cz</a>

Výsledek na webu

<a href="https://www.sciencedirect.com/science/article/pii/S2405500X16305242#" target="_blank" >https://www.sciencedirect.com/science/article/pii/S2405500X16305242#</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.jacep.2016.12.010" target="_blank" >10.1016/j.jacep.2016.12.010</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Resting and exercise-induced left atrial hypertension in patients with atrial fibrillation: The causes and implications for catheter ablation

Popis výsledku v původním jazyce

Objectives The aim of this paper was to investigate the prevalence of resting and exercise-induced left atrial hypertension (LAH) in patients with nonvalvular atrial fibrillation (AF), association of the LAH with other cardiac abnormalities, and its implications for AF catheter ablation. Background The clinical role of LAH in patients with established AF is largely unknown. Methods: Patients scheduled for catheter ablation of AF (n = 240; age 60 ± 10 years; 67% men, 62% paroxysmal AF) underwent detailed echocardiography, assessment of quality of life (QoL), left atrial (LA) voltage mapping, and measurement of the LA pressure at rest and during isometric handgrip exercise. After ablation they were followed for AF recurrence for 16 ± 6 months. Results: Resting and exercise-induced LAH (mean LA pressure &gt;15 mm Hg) occurred in 15% and 34% of the patients, respectively. Both the patients with resting and exercise-induced LAH had typical features of latent heart failure with preserved ejection fraction associated with advanced LA structural and functional remodeling. AF recurred after ablation in 45% of the patients. LAH was an independent risk factor for arrhythmia recurrence (hazard ratio: 1.7, 95% confidence interval: 1.2 to 2.2). The patients with LAH had worse baseline QoL, but they benefited significantly more from a successful ablation than the patients without LAH. Conclusions: Presence of either resting or exercise-induced LAH identified AF patients with a distinct clinical profile, extensive LA substrate, and different clinical response to catheter ablation. Stratification of AF patients based on the LA exercise hemodynamics could help in the future to tailor the ablation strategy.

Název v anglickém jazyce

Resting and exercise-induced left atrial hypertension in patients with atrial fibrillation: The causes and implications for catheter ablation

Popis výsledku anglicky

Objectives The aim of this paper was to investigate the prevalence of resting and exercise-induced left atrial hypertension (LAH) in patients with nonvalvular atrial fibrillation (AF), association of the LAH with other cardiac abnormalities, and its implications for AF catheter ablation. Background The clinical role of LAH in patients with established AF is largely unknown. Methods: Patients scheduled for catheter ablation of AF (n = 240; age 60 ± 10 years; 67% men, 62% paroxysmal AF) underwent detailed echocardiography, assessment of quality of life (QoL), left atrial (LA) voltage mapping, and measurement of the LA pressure at rest and during isometric handgrip exercise. After ablation they were followed for AF recurrence for 16 ± 6 months. Results: Resting and exercise-induced LAH (mean LA pressure &gt;15 mm Hg) occurred in 15% and 34% of the patients, respectively. Both the patients with resting and exercise-induced LAH had typical features of latent heart failure with preserved ejection fraction associated with advanced LA structural and functional remodeling. AF recurred after ablation in 45% of the patients. LAH was an independent risk factor for arrhythmia recurrence (hazard ratio: 1.7, 95% confidence interval: 1.2 to 2.2). The patients with LAH had worse baseline QoL, but they benefited significantly more from a successful ablation than the patients without LAH. Conclusions: Presence of either resting or exercise-induced LAH identified AF patients with a distinct clinical profile, extensive LA substrate, and different clinical response to catheter ablation. Stratification of AF patients based on the LA exercise hemodynamics could help in the future to tailor the ablation strategy.

Druh

J_SC - Článek v periodiku v databázi SCOPUS

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2017

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

JACC : Clinical electrophysiology

ISSN

2405-5018

e-ISSN

—

Svazek periodika

3

Číslo periodika v rámci svazku

5

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

9

Strana od-do

461-469

Kód UT WoS článku

—

EID výsledku v databázi Scopus

2-s2.0-85014091742