Paroxysmal atrial fibrillation with high vs. low arrhythmia burden: atrial remodelling and ablation outcome
| Autor: | Rene Tavernier, Y Vandekerckhove, Thomas Phlips, M El Haddad, Teresa Strisciuglio, Alexandre Almorad, Mattias Duytschaever, Maria Kyriakopoulou, Michael Wolf, Philippe Debonnaire, Anthony Demolder, S Knecht, J De Pooter |
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| Přispěvatelé: | Strisciuglio, T, El Haddad, M, Debonnaire, P, De Pooter, J, Demolder, Anthony, Wolf, M, Phlips, T, Kyriakopoulou, M, Almorad, A, Knecht, S, Tavernier, R, Vandekerckhove, Y, Duytschaever, Mattias |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Refractory period medicine.medical_treatment Catheter ablation Nerve conduction velocity Physiology (medical) Internal medicine Atrial Fibrillation medicine Humans Heart Atria Atrial tachycardia Atrium (architecture) business.industry Cardiac arrhythmia Atrial fibrillation Atrial Remodeling Cardiac Ablation medicine.disease Treatment Outcome Pulmonary Veins Catheter Ablation Cardiology medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | EP Europace. 22:1189-1196 |
| ISSN: | 1532-2092 1099-5129 |
| DOI: | 10.1093/europace/euaa071 |
| Popis: | Aims The relation between atrial tachyarrhythmia (ATA) burden in paroxysmal atrial fibrillation (AF), atrial remodelling, and efficacy of catheter ablation (CA) is unknown. We investigated whether high vs. low-burden paroxysmal AF patients have distinct clinical characteristics or electro-mechanical properties of the left atrium (LA) and whether burden impacts outcome of CA. Methods and results Atrial tachyarrhythmia burden, defined as the percentage of time spent in ATA, was assessed by insertable cardiac monitors in 105 patients before and after CA. Clinical characteristics and electro-mechanical properties of LA were compared between patients with high vs. low ATA burden. Catheter ablation efficacy was assessed by reduction in ATA burden and 1-year freedom from any ATA. Median ATA burden was 2.7% (highest tertile 9.3%). Clinical characteristics and electrical properties of LA (refractoriness, conduction velocity, low voltage) did not differ between high (≥9.3%) vs. low ATA burden ( Conclusion Paroxysmal AF patients with high ATA burden have altered LA mechanical properties, reflected by larger size and impaired function. Despite mechanical remodelling of the atria, they are excellent responders to CA. Most likely the lack of fibrosis and/or advanced electrical remodelling explain why pulmonary veins remain the dominant trigger for AF in this patient cohort. |
| Databáze: | OpenAIRE |
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