Predictive Factors of Recurrence of AF after Catheter Ablation—The Significance of LAA Velocity and eGFR—
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概要
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<B>Backgrounds:</B> Our aim was to investigate the predictors of AF recurrence after circumferential pulmonary vein isolation (CPVI) and additional substrate ablation. <B>Methods:</B> A total of 200 consecutive AF patients (70% paroxysmal, 30% persistent/chronic) underwent catheter ablation (CA) using CARTO merge system with a irrigated-tip catheter were studied. The strategy of CA was CPVI for paroxysmal AF, and CPVI with mitral isthmus, septum, roof line ablation and CFAEs ablation for persistent/chronic AF. Recurrence was defined as proof of AF with ECG in every visit after CA. <B>Results:</B> With mean follow-up of 9.2±3.2 months, 160 patients (80%) were free from AF. In multivariate analyses, types of AF, ejection fraction, left atrial diameter, presence of structural heart disease, BNP level, early AF recurrence and duration of AF did not predict the AF recurrence. Multivariate Cox proportional hazards regression analysis revealed that the eGFR (HR 1.37 per 10 mL/min/1.73 m<SUP>2</SUP> decrease, 95% CI 1.18 to 1.59, P<0.001), and blood velocity in left atrial appendage (LAA) (HR 1.28 per 10 cm/s decrease, 95% CI 1.05 to 1.56, P=0.005) were independent predictors of AF recurrence. <B>Conclusion:</B> The LAA velocity and eGFR are independent predictors of AF recurrence after CA. Patients with low velocity in LAA and/or low eGFR would need intensive strategy and careful follow-up.
著者
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Nakamura Keijiro
Cardio vascular cnter. TOHO Universty School of Medicine, Sakura hospital
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Kumagai Koji
Cardiovascular Center Yokosuka Kyosai General Hospital
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Nishiuchi Suguru
Cardiovascular Center Osaka Red Cross Hospital
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Naito Shigeto
Cardiology Division Gunma Cardiovascular Center
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Sakamoto Tamotsu
Cardiovascular Division Gunma Prefecture Cardiovascular Center
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Miki Yuko
Cardiology, Gunma Prefectural Cardiovascular Center
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Fuke Etsuko
Cardiology, Gunma Prefectural Cardiovascular Center
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Nakamura Kouki
Cardiology, Gunma Prefectural Cardiovascular Center
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Kaseno Kenichi
Cardiology, Gunma Prefectural Cardiovascular Center
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Naito Shigeto
Cardiology, Gunma Prefectural Cardiovascular Center
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Nishiuchi Suguru
Cardiology, Gunma Prefectural Cardiovascular Center
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Sakamoto Tamotsu
Cardiology, Gunma Prefectural Cardiovascular Center
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Nakamura Keijiro
Cardiology, Gunma Prefectural Cardiovascular Center
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