Abstract
Background
The relationship between coronary blood flow during atrial fibrillation (AF) and improvement of cardiac function after catheter ablation (CA) for persistent AF (PeAF) is not prominent; this study was conducted to evaluate this relationship.
Methods
This was a retrospective case–control study. Eighty-five patients with PeAF (resting heart rate < 100 bpm) and heart failure with reduced ejection fraction (left ventricular ejection fraction (LVEF) < 40%) who had undergone coronary angiography within 1 week before CA were included. All patients could maintain a sinus rhythm for > 6 months after CA. The primary outcome was improvement of cardiac function with an LVEF cutoff value of > 50% during sinus rhythm 6 months after CA.
Results
In the LVEF improvement group (N = 57), patients were younger, with a higher baseline diastolic blood pressure and lower baseline brain natriuretic peptide level than the no LVEF improvement group (N = 28). Heart rate at baseline and 6 months after CA and AF duration did not differ between the two groups. Thrombolysis in myocardial infarction frame count parameters was significantly higher in the LVEF improvement (P < 0.001) than in the no LVEF improvement group. Multivariate logistic regression analysis revealed mean thrombolysis in myocardial infarction frame count as an independent factor for LVEF improvement (odds ratio, 1.72 (95% confidence interval 1.17–2.54); P = 0.006).
Conclusion
Coronary blood flow in patients with PeAF is strongly associated with improved left ventricular systolic function after the restoration of sinus rhythm by CA for PeAF and heart failure with reduced ejection fraction.
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Data availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.
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Acknowledgements
The authors would like to thank all members of the Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan. The authors did not receive support from any organization for the submitted work.
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M.T. designed the study, the main conceptual ideas, and the proof outline. M.T., T.A., and T.K. collected the data. M.T., R.H., and S.F. aided in interpreting the results and worked on the manuscript. M.H. supervised the project. M.T. wrote the manuscript with support from S.F. and M.H.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Ethical Review Board of Tokyo Metropolitan Hiroo Hospital (No. 15).
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Takahashi, M., Arai, T., Kimura, T. et al. Relationship between coronary blood flow and improvement of cardiac function after catheter ablation for persistent atrial fibrillation. J Interv Card Electrophysiol 66, 2063–2070 (2023). https://doi.org/10.1007/s10840-023-01542-8
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DOI: https://doi.org/10.1007/s10840-023-01542-8