Abbreviations
Atrial fibrillation (AF)
Heart Failure (HF)
Right Atrial Pressure (RAP)
Left Atrial Pressure (LAP)
Chronic Kidney Disease (CKD)
Catheter Ablation (CA)
INTRODUCTION
Atrial fibrillation is the commonest arrhythmia worldwide, and is projected to increase in frequency as the population ages. (1,2) The cornerstone of AF management is symptom control, and multiple studies suggest catheter ablation is a safe and effective procedure to reduce symptoms from AF. (3,4) Procedure efficacy has remained the same, but newer techniques and technologies are making for a safer procedure. Nevertheless, one major complication is incident HF requiring office visits, medicine titration, emergency room visits, or hospitalization, which can be as high as 20%. (5-10)
Atrial fibrillation and HF frequently coexist in this population, with AF prevalence ranging from 5% in patients with mild HF up to 50% in patients with severe HF. (11) These disease processes share numerous risk factors such as obesity, hypertension and diabetes, resulting in adverse cellular remodeling, neurohormonal changes and increased LAP. (12) Several studies have correlated elevated intraoperative LAP with increased risk of recurrent AF after ablation. (7,13-17) Elevated LAP also correlates with symptomatic HF but few studies have examined the relationship between early incident HF and LAP during AF ablation. (18) The aim of our study is to examine how LAP before and after ablation affects postoperative HF.
METHODS