Atrial functional mitral regurgitation in patients qualified for pulmonary vein isolation: a negative prognostic factor for catheter ablation efficacy. (14th October 2021)

• Record Type: Journal Article
• Authors: Cichon, M; Wybraniec, M; Mizia-Szubryt, M; Mizia-Stec, K
• Is Part Of: European heart journal. Volume 42(2021)Supplement 1
• Publication Date: 2021-10-14
• Subjects: Catheter Ablation of Arrhythmias; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/ehab724.0353
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Background: Atrial functional mitral regurgitation (AF-MR) related to atrial fibrillation (AF) could affect the effectiveness of the sinus rhythm restoring procedures. Purpose: The aim of the study was to evaluate the impact of AF-MR on pulmonary vein isolation (PVI) efficacy. Methods: One hundred thirty-six patients (65.4% males; mean age 56±11 years) with symptomatic paroxysmal or persistent AF qualified for PVI were enrolled into the study. AF-MR assessment was performed in transthoracic (TTE) and transesophageal (TEE) echocardiography before PVI procedure. PVI efficacy was evaluated in 3-month and long-term follow-up. Results: AF-MR was diagnosed in 74.3% patient in transthoracic echocardiography (TTE) (trace: 26.5%, mild: 43.4%, moderate: 3.7%, severe 0.7%) and 94.9% in transesophageal echocardiography (TEE) (trace: 17.6%, mild: 59.6%, moderate: 16.2%, severe: 1.5%). PVI 3-month efficacy was 75.7% in 3-month and 64% in the long-term observation. Severe AF-MR in TEE at baseline was associated with lower 3-month PVI efficacy (P=0.012) while moderate to severe AF MR in TEE was related to inefficient PVI assessed in long-term follow-up (P=0.041). In Kaplan- Meier analysis only moderate to severe AF-MR diagnosed in TEE had an impact on long-term procedure outcome (P=0.048). Conclusions: Significant AF-MR confirmed by TEE predicts 3-month as well as long-term PVI efficacy. Funding Acknowledgement: Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The institutional budget of the First Department of Cardiology, Medical University of Silesia, Katowice, Poland