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Left atrial hypertension and the risk of early incident heart failure after atrial fibrillation ablation
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  • Jasen Gilge,
  • Asim Ahmed,
  • Brad Clark,
  • Alexander Slaten,
  • Rahul Devathu,
  • Jeff Olson,
  • Benzy Padanilam,
  • Girish Nair,
  • Sandeep Joshi,
  • Ashwin Ravichandran,
  • Parin Patel
Jasen Gilge
Ascension St Vincent Hospital Indianapolis
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Asim Ahmed
St. Vincent Health
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Brad Clark
St. Vincent Health
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Alexander Slaten
Ascension St Vincent Hospital Indianapolis
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Rahul Devathu
Ascension St Vincent Hospital Indianapolis
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Jeff Olson
St Vincent
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Benzy Padanilam
St. Vincent Health
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Girish Nair
St. Vincent Medical Group
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Sandeep Joshi
Ascension St Vincent Hospital Indianapolis
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Ashwin Ravichandran
St. Vincent Medical Group
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Parin Patel
Ascension St Vincent Hospital Indianapolis
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Abstract

Introduction: Elevated left atrial pressure (LAP) during catheter ablation of atrial fibrillation (AF) is associated with an increased risk of AF recurrence, but it is unknown if this correlates with heart failure (HF). The objective of the study was to determine if elevated LAP after AF ablation correlates with HF events. Methods: Prospective, single center, cohort study measuring LAP and RAP during AF ablation in 100 patients. The primary endpoint was clinical HF within 30 days of ablation. The secondary outcome was AF-free HF. Results: 100 patients (63% male, mean age 64.5) were enrolled and 20% had clinical HF within 30 days. Bivariate correlates included mitral valve (MV) disease, persistent AF, class III antiarrhythmics, LAP, and recurrent AF. Multivariate analysis revealed class III antiarrhythmics were protective (OR 0.24 [0.1–0.5], p=0.04), while MV disease (OR 8.7 [3.3—23], p=0.03) and loop diuretics (OR 4.8 [2.6–9.1], p=0.01) were hazardous. AF-free HF occurred in 9% of patients and correlated with higher LAP and RAP, and CKD. Conclusion: Patients with HF after AF ablation had higher LAP. MV disease, diuretic use, and class III antiarrhythmics also correlated to HF. These present opportunities to target future interventions to reduce a common complication of AF ablation.

Peer review status:Published

19 Sep 2020Submitted to Journal of Cardiovascular Electrophysiology
21 Sep 2020Submission Checks Completed
21 Sep 2020Assigned to Editor
25 Sep 2020Reviewer(s) Assigned
20 Oct 2020Review(s) Completed, Editorial Evaluation Pending
21 Oct 2020Editorial Decision: Revise Minor
03 Nov 20201st Revision Received
04 Nov 2020Submission Checks Completed
04 Nov 2020Assigned to Editor
04 Nov 2020Reviewer(s) Assigned
18 Nov 2020Review(s) Completed, Editorial Evaluation Pending
23 Nov 2020Editorial Decision: Accept
14 Dec 2020Published in Journal of Cardiovascular Electrophysiology. 10.1111/jce.14829