5A.03: IMPACT OF MAIN RISK FACTORS OF THROMBOEMBOLIC EVENTS CHA2DS2-VASC SCORE ON THE EFFICACY OF CATHETER ABLATION OF ATRIAL FIBRILLATION IN PATIENTS WITH IMPLANTABLE ECG MONITOR. (June 2015)

• Record Type: Journal Article
• Authors: Vachulova, A.; Cerna, H.; Urban, L.; Svetlosak, M.; Vohnout, B.; Hlivak, P.; Margitfalvi, P.; Bernat, V.; Gladisova, K.; Sasov, M.; Hatala, R.
• Is Part Of: Journal of hypertension. Volume 33(2015)Supplement 1
• Publication Date: 2015-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000467519.36510.12
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Arterial hypertension (AH), especially not controlled, has a pivotal role in the pathogenesis and persistence of atrial fibrillation (AF). AH is included in each risk stratification of thromboembolic events (CHADS2 and CHADS2-VASC2 scores). Catheter ablation of atrial fibrillation (CA AF) has proved as an effective intervention method for cure highly symptomatic patients with AF. This study aimed to determine the impact of AH and other risk factors from CHADS2-VASC2 score on the outcome CA AF. The outcome was evaluated as the overall AF burden (defined as the amount of time spent in AF). This parameter could be exactly quantified with an implantable ECG monitor, values are 0–100 % (100% = long persistent AF). Design and method: We retrospectively analysed 133 patients (108 males - 81%), mean age 55 ± 9 years with paroxysmal/persistent AF. Patients underwent CA AF in the period of 9 years (2005–2013) and were monitored with an implatable ECG monitor (REVEAL XT, Medtronic). CA substrate of AF was was realised with mapping system application of radiofrequency energy by cooling catheter with the aim to achieve permanent electrical isolation of pulmonary veins. Results: Arterial hypertension was presented in 104 (78.2%) patients. Averall AF burden was before CA AF 21.70 ± 17.9 %, 12 -15 months after CA AF 5.14 ± 12.5, AF burden drop was 16.56. We recorded statistically significant reduction AF burden after CA AF, with maximal drop at the 9 month after CA AF. AF burden reduction was not dependent on the CHA2DS2-VASc score. Conclusions: Accumulation of the risk factors expressed in the CHA2DS2-VASc score, especially AH, is a certain parameter of overall morbidity of the patient. For the efficacy of CA AF is important to obtain pre- and post- procedural blood pressure control. Our analysis suggest that higher level CHA2DS2-VASc score did not influenced long term efficacy of CA AF. It can therefore be considered CA AF also in patients with paroxysmal/persitent AF with higher incidence of cardiovascular comorbidities.