All Authors are from the
St Vincent Medical Group, 8333 Naab Road, #400,Indianapolis, IN 46260. Department of Internal Medicine, Division of
Cardiology
Conflict of interest : Parin Patel serves on an advisory panel
for Medtronic, Inc. Ashwin Ravichandran reports speaking honoraria and
travel support from Abbott and Medtronic. The remaining authors have no
conflicts to disclose.
Financial disclosure : None
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.
Key Words : Atrial fibrillation, ablation, congestive heart
failure
Word Count : 4130