Repurposing catheter ablation work-up to detect expiratory airflow limitation in patients with atrial fibrillation.

Autor:	Hereijgers MJM; Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands.; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands., van der Velden RMJ; Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands.; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands., El Moussaoui N; Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands., Verhaert DVM; Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands.; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands.; Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands., Habibi Z; Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands.; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands.; Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands., Luermans J; Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands.; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands., den Uijl D; Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands.; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands., Chaldoupi SM; Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands.; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands., Vernooy K; Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands.; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands., Schotten U; Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands.; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands.; Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands., Baumert M; Discipline of Biomedical Engineering, The University of Adelaide, Adelaide, Australia., Gietema HA; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.; GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands., Mihl C; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands.; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands., Koltowski L; First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland., Franssen FME; Department of Research and Development, Ciro, Horn, The Netherlands.; Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands., Simons SO; Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.; NUTRIM Research Institute of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands., Linz D; Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands.; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands.; Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.; Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Jazyk:	angličtina
Zdroj:	International journal of cardiology. Heart & vasculature [Int J Cardiol Heart Vasc] 2023 Nov 17; Vol. 49, pp. 101305. Date of Electronic Publication: 2023 Nov 17 (Print Publication: 2023).
DOI:	10.1016/j.ijcha.2023.101305
Abstrakt:	Background: In atrial fibrillation (AF) patients, presence of expiratory airflow limitation may negatively impact treatment outcomes. AF patients are not routinely screened for expiratory airflow limitation, but existing examinations can help identify at-risk individuals. We aimed to assess the diagnostic value of repurposing existing assessments from the pre-ablation work-up to identify and understand the characteristics of affected patients. Methods: We screened 110 consecutive AF patients scheduled for catheter ablation with handheld spirometry. Routine pre-ablation work-up included cardiac computed tomographic angiography (CCTA), transthoracic echocardiography and polygraphy. CCTA was analyzed qualitatively for emphysema and airway abnormalities. Multivariate logistic regression analysis was performed to determine predictors of expiratory airflow limitation. Results: We found that 25 % of patients had expiratory airflow limitation, which was undiagnosed in 86 % of these patients. These patients were more likely to have pulmonary abnormalities on CCTA, including emphysema (odds ratio [OR] 4.2, 95 % confidence interval [CI] 1.12-15.1, p < 0.05) and bronchial wall thickening (OR 2.6, 95 % CI 1.0-6.5, p < 0.05). The absence of pulmonary abnormalities on CCTA accurately distinguished patients with normal lung function from those with airflow limitation (negative predictive value: 85 %). Echocardiography and polygraphy did not contribute significantly to identifying airflow limitation. Conclusions: In conclusion, routine pre-ablation CCTA can detect pulmonary abnormalities in AF patients with airflow limitation, guiding further pulmonary assessment. Future studies should investigate its impact on ablation procedure success. Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [US received grants, consultancy fees or honoraria from Università della Svizzera Italiana (USI, Switzerland), EP Solutions Inc. (Switzerland), Johnson & Johnson Medical Limited, (United Kingdom), Bayer Healthcare (Germany). US is co-founder and shareholder of YourRhythmics BV, a spin-off company of the University Maastricht.]. (© 2023 The Author(s).)
Databáze:	MEDLINE
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