AF-free HF Events
Recurrent AF post-ablation may be a risk factor for developing HF but this only accounts for about half of the HF events in our study population. In the remaining patients, we found the presence of CKD and elevated RAP and LAP post-ablation correlated with AF-free HF events. Elevated atrial pressures, if not appropriately reduced, likely results in pulmonary vascular congestion and HF symptoms. This may provide a unique marker for patients at risk of developing a subsequent HF episode and provide an opportunity for intervention. A reasonable trigger for intervention may be the sum of the LAP and RAP greater than or equal to 20 mmHg based on this data (encompassing 77.8% of those with incident HF without a recurrence of AF), but further study is warranted for validation, as this would apply to 33% of the entire population.