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Journal of Interventional Cardiac Electrophysiology

Erschienen in:

29.01.2016

Increased left atrial pressure predicts recurrence following successful cryoablation for atrial fibrillation with second-generation cryoballoon

verfasst von: Banu Evranos, Duygu Kocyigit, Kadri Murat Gurses, Muhammed Ulvi Yalcin, Mehmet Levent Sahiner, Ergun Baris Kaya, Necla Ozer, Kudret Aytemir

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 2/2016

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Abstract

Purpose

Several studies have demonstrated that left ventricular diastolic dysfunction (LVDD) and left atrial pressure (LAP), as a surrogate marker of LVDD, were associated with atrial fibrillation (AF) recurrence following radiofrequency catheter ablation (RFCA) for AF. In this study, we aimed to investigate the individual impact of several left ventricular diastolic function parameters on outcomes of cryoablation for paroxysmal AF using second-generation cryoballoon.

Methods

One hundred seventy patients who were scheduled for cryoablation with second-generation cryoballoon were included in this prospective study. All patients underwent comprehensive transthoracic and transesophageal echocardiographic examinations during sinus rhythm a day before catheter ablation. LAP was measured via transseptal sheath at the beginning of the ablation procedure.

Results

One hundred seventy patients (57.09 ± 11.80 years, 47.06 % male) were involved in the study. At a median follow-up of 19 months, when blanking period of 3 months was considered, freedom from AF after a single ablation procedure was 84.71 %. Patients with AF recurrence had significantly greater left atrial volume index (LAVI) (p = 0.005) and LAP (p < 0.001). Patients with AF recurrence had lower septal eʹ wave (p = 0.013), and higher E/eʹ ratio (p = 0.014). LAVI (p = 0.007) and LAP (p = 0.006) were independent predictors of AF recurrence. A cut-off value of 13.50 mmHg for LAP measured during the procedure was associated with a sensitivity and specificity of 80.8 and 84.7 % (p = 0.005) for predicting AF recurrence.

Conclusions

Pre-procedural LAVI and procedural LAP measurement have clinical importance in predicting AF recurrence in patients undergoing cryoablation with second-generation cryoballoon. Effectiveness of cryoablation is reduced in patients with greater LAVI and LAP.

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Titel: Increased left atrial pressure predicts recurrence following successful cryoablation for atrial fibrillation with second-generation cryoballoon
verfasst von: Banu Evranos
Duygu Kocyigit
Kadri Murat Gurses
Muhammed Ulvi Yalcin
Mehmet Levent Sahiner
Ergun Baris Kaya
Necla Ozer
Kudret Aytemir
Publikationsdatum: 29.01.2016
Verlag: Springer US
Erschienen in: Journal of Interventional Cardiac Electrophysiology / Ausgabe 2/2016
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI: https://doi.org/10.1007/s10840-016-0107-8

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