Efficacy of catheter ablation for atrial fibrillation in patients with significant functional mitral regurgitation. Issue 10 (10th March 2023)

• Record Type: Journal Article
• Authors: Zhao, Danqing; Zhang, Futao; Liu, Xiaojie; Li, Muzhang; Zhang, Leiming; Hu, Juan; Li, Feifei; Wu, Jintao
• Is Part Of: Medicine. Volume 102:Issue 10(2023)
• Page Start: e33231
• Publication Date: 2023-03-10
• Subjects: atrial fibrillation -- catheter ablation -- functional mitral regurgitation -- recurrence; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000033231
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Background: Catheter ablation has been established to be an effective therapy for paroxysmal atrial fibrillation (AF) and is recommended as the treatment of choice for many patients, including those with clinically significant functional mitral regurgitation (MR). However, there is little information available about the clinical efficacy of catheter ablation for paroxysmal AF in patients with significant functional MR. Methods: We performed a retrospective study of 247 patients with paroxysmal AF who underwent AF ablation. The study included 28 (11.3%) patients with significant functional MR and 219 (88.7%) without significant functional MR. AF recurrence was defined as the occurrence of confirmed atrial tachyarrhythmia lasting >30 seconds beyond 3 months after catheter ablation. Results: During a mean follow-up of 20.1 ± 7.4 months (range, 3–36 months), 45 (18.2%) patients developed recurrence of AF. The recurrence rate of AF was higher in patients with significant functional MR than in those without significant functional MR (42.9% vs 15.1%; P < .001). Univariable Cox proportional hazards regression analysis showed that significant functional MR (hazard ratio [HR], 3.46; 95% confidence interval [CI], 1.78–6.72; P < .001), age (HR, 1.04; 95% CI, 1.01–1.08; P = .009), the CHA2 DS2 -VASc score (HR, 1.28; 95% CI, 1.05–1.56; P = .017), and heart failure (HR, 4.71; 95% CI, 1.85–11.96; P = .001) were associated with the risk of recurrence. Multivariable analysis showed that significant functional MR (HR, 2.48; 95% CI, 1.21–5.05; P = .013), age (HR, 1.04; 95% CI, 1.00–1.07; P = .031), and heart failure (HR, 3.39; 95% CI, 1.27–9.03; P = .015) were independent predictors of AF recurrence. Conclusion: Patients with significant functional MR have an increased risk of AF recurrence after catheter ablation.