Significance of mitral L‐waves in predicting late recurrences of atrial fibrillation after radiofrequency catheter ablation. Issue 1 (30th November 2022)

• Record Type: Journal Article
• Authors: Wada, Ryo; Shinohara, Masaya; Fujino, Tadashi; Matsumoto, Shingo; Yao, Shintaro; Yano, Kensuke; Dobashi, Shintaro; Akitsu, Katsuya; Koike, Hideki; Ohara, Hiroshi; Kinoshita, Toshio; Yuzawa, Hitomi; Nakanishi, Rine; Ikeda, Takanori
• Is Part Of: Pacing and clinical electrophysiology. Volume 46:Issue 1(2023)
• Page Start: 73
• Page End: 83
• Publication Date: 2022-11-30
• Subjects: atrial fibrillation -- catheter ablation -- mitral L‐wave; Cardiac pacing -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1111/pace.14632
• Languages: English
• ISSNs: 0147-8389

Abstract

Abstract: Background: The mitral L‐wave, a prominent mid‐diastolic filling wave in echocardiographic examinations, is associated with severe left ventricular diastolic dysfunction. The relationship between the mitral L‐wave and outcome of catheter ablation (CA) in patients with atrial fibrillation (AF) has not been established. This study aimed to evaluate the predictive value of mitral L‐waves on AF recurrence after CA. Methods: This was a retrospective and observational study in a single center. One hundred forty‐six patients (mean age; 63.9 [56.0–72.0] years, 71.9% male) including 66 non‐paroxysmal AF patients (45.2%) who received a first CA were enrolled. The mitral L‐waves were defined as a distinct mid‐diastolic flow velocity with a peak velocity ≥20 cm/s following the E wave in the echocardiographic examinations before CA. The patients enrolled were divided into groups with ( n = 31, 21.2%) and without ( n = 115, 78.8%) mitral L‐waves. Univariate and multivariate analyses were carried out to determine the predictive factors of late recurrences of AF (LRAFs), which meant AF recurrence later than 3 months after the CA. Results: During a follow‐up of 28.8 (15.0–35.8) months, the ratio of LRAFs in patients with mitral L‐waves was significantly higher than that in those without mitral L‐waves (15 [46.9%] vs. 16 [14.0%], p < .001). A multivariate analysis using a Cox proportional hazard model revealed that the mitral L‐waves were a significant predictive factor of LRAFs (hazard ratio: 3.09, 95% confidence interval: 1.53–6.24, p = .002). Conclusion: The appearance of mitral L‐waves could predict LRAFs after CA.