TY - JOUR
T1 - Predictors of recurrence after pulmonary vein isolation in patients with normal left atrial diameter
AU - Yano, Masamichi
AU - Egami, Yasuyuki
AU - Yanagawa, Kyosuke
AU - Matsuhiro, Yutaka
AU - Nakamura, Hitoshi
AU - Yasumoto, Koji
AU - Okamoto, Naotaka
AU - Tanaka, Akihiro
AU - Matsunaga-Lee, Yasuharu
AU - Nakamura, Daisuke
AU - Yamato, Masaki
AU - Shutta, Ryu
AU - Nishino, Masami
AU - Tanouchi, Jun
N1 - Publisher Copyright:
© 2019 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Heart Rhythm Society.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Background: Enlarged left atrium (LA) is an established predictor of recurrence of atrial fibrillation (AF) after pulmonary vein isolation (PVI), but occasionally recurrences of AF/atrial tachycardia (AT) are experienced in patients with normal left atrial diameter. Therefore, the predictors of AF recurrence and AF triggers were evaluated in patients with normal LA. Methods: We enrolled 168 patients with normal LA (<40 mm) who underwent PVI. Various predictors were compared, including age, gender, coronary risk factors, brain natriuretic peptide (BNP), medications, echocardiographic parameters, and procedure parameters, between recurrence and nonrecurrence groups. Results: The recurrence group consisted of 50 patients (29.8%). A univariate analysis demonstrated that the ratio of females, high BNP levels, severe tricuspid valve regurgitation (TR), and relapses of AF/AT during catheter ablation (CA) were significantly higher in the recurrence group. Multivariate analyses showed that a high BNP, severe TR, and AF/AT relapses during CA were independent factors associated with AF recurrence. During the second CA sessions, nonpulmonary vein (PV) triggers were therapeutic targets in 18 patients (46.2%), which was higher than that previously reported. Conclusion: A high BNP, severe TR and AF/AT relapses during CA may be correlated with AF recurrence after PVI in the patients with normal LA.
AB - Background: Enlarged left atrium (LA) is an established predictor of recurrence of atrial fibrillation (AF) after pulmonary vein isolation (PVI), but occasionally recurrences of AF/atrial tachycardia (AT) are experienced in patients with normal left atrial diameter. Therefore, the predictors of AF recurrence and AF triggers were evaluated in patients with normal LA. Methods: We enrolled 168 patients with normal LA (<40 mm) who underwent PVI. Various predictors were compared, including age, gender, coronary risk factors, brain natriuretic peptide (BNP), medications, echocardiographic parameters, and procedure parameters, between recurrence and nonrecurrence groups. Results: The recurrence group consisted of 50 patients (29.8%). A univariate analysis demonstrated that the ratio of females, high BNP levels, severe tricuspid valve regurgitation (TR), and relapses of AF/AT during catheter ablation (CA) were significantly higher in the recurrence group. Multivariate analyses showed that a high BNP, severe TR, and AF/AT relapses during CA were independent factors associated with AF recurrence. During the second CA sessions, nonpulmonary vein (PV) triggers were therapeutic targets in 18 patients (46.2%), which was higher than that previously reported. Conclusion: A high BNP, severe TR and AF/AT relapses during CA may be correlated with AF recurrence after PVI in the patients with normal LA.
KW - atrial fibrillation
KW - normal left atrial diameter
KW - pulmonary vein isolation
KW - recurrence
UR - https://www.scopus.com/pages/publications/85071552548
U2 - 10.1002/joa3.12230
DO - 10.1002/joa3.12230
M3 - Article
AN - SCOPUS:85071552548
SN - 1880-4276
VL - 36
SP - 75
EP - 81
JO - Journal of Arrhythmia
JF - Journal of Arrhythmia
IS - 1
ER -