One-Year Change in the H 2 FPEF Score After Catheter Ablation of Atrial Fibrillation in Patients With a Normal Left Ventricular Systolic Function

Frontiers in Cardiovascular Medicine

article

Min Kim¹  Hee Tae Yu²  Tae-Hoon Kim²  Jae-Sun Uhm²  Boyoung Joung²  Moon-Hyoung Lee²  Hui-Nam Pak² 

[1] Division of Cardiology, Chungbuk National University Hospital;Division of Cardiology, Yonsei University Health System

关键词: atrial fibrillation;    catheter ablation;    left venticular diastolic dysfunction;    recurrent event;    risk score;   

DOI  :  10.3389/fcvm.2021.699364

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Background: It is unclear whether atrial fibrillation (AF) catheter ablation (AFCA) improves the left ventricular (LV) diastolic function. We evaluated the 1-year change in the H 2 FPEF score, which reflects the degree of LV diastolic function, after AFCA among patients with a normal LV systolic function. Methods and Results: We included 1,471 patients (30.7% female, median age 60 years, paroxysmal-type AF 68.6%) who had available H 2 FPEF scores at baseline and at 1-year after AFCA to evaluate the 1-year change in the H 2 FPEF score (ΔH 2 FPEF score [1−yr] ) after AFCA. Baseline high H 2 FPEF scores (≥6) were independently associated with the female sex, left atrium (LA) diameter, LV mass index, pericardial fat volume, and a low estimated glomerular filtration rate. One year after AFCA, decreased ΔH 2 FPEF scores [1−yr] were associated with baseline H 2 FPEF scores of ≥6 [OR, 4.19 (95% CI, 2.88–6.11), p < 0.001], no diabetes [OR, 0.60 (95% CI, 0.37–0.98), p = 0.04], and lower pericardial fat volume [OR, 0.99 (95% CI, 0.99–1.00), p = 0.003]. Increased ΔH 2 FPEF scores [1−yr] were associated with a baseline H 2 FPEF score of <6 [OR, 3.54 (95% CI, 2.08–6.04), p < 0.001] and sustained AF after a recurrence within 1 year [SustainAF [1−yr] ; OR, 1.89 (95% CI, 1.01–3.54), p = 0.048]. Throughout a 56-month median follow-up, an increased ΔH 2 FPEF score [1−yr] resulted in a poorer rhythm outcome of AFCA (at 1 year, log-rank p = 0.003; long-term, log-rank p = 0.010). Conclusions: AFCA appears to improve LV diastolic dysfunction. However, SustainAF [1−yr] may contribute to worsening LV diastolic dysfunction, and it was shown by increased ΔH 2 FPEF scores [1−yr] , which was independently associated with higher risk of AF recurrence rate after AFCA. Clinical Trial Registration: ClinicalTrials.gov Identifier: {"type":"clinical-trial","attrs":{"text":"NCT02138695","term_id":"NCT02138695"}} NCT02138695 .

【 授权许可】

CC BY