Efficiency of radiofrequency ablation of pulmonary vein ostium for patients with atrial fibrillation and metabolics
Abstract
The aim of this study is determination of predictors of efficiency of radiofrequency ablation (RFA) in patients with atrial fibrillation (AF) and metabolic syndrome (MS). Material and methods. 98 patients with AF (78 patients with AF and MS (IDF, 2005) and 20 patients without MS) have been examined. Comparison groups included 50 patients with MS without arrhythmia and 50 practically healthy subjects. RFA was performed with Carto 3 navigation system. Follow-up period after RFA was 12 months. Epicardial fat thickness (EFT) was measured with help of echo-cardiography. Results: patients with AF relapse had more MS components than those with effective procedure (3.21±1.18 and 1.73±1.14, accordingly, p<0.001). Initially, EFT of patients with AF relapse after RFA was larger that in patients without arrhythmia after exposure. EFT in patients with AF more than3.5 mmincreases probability of arrhythmia relapse in 1.87 times (OR: 1.87, 95 % CI 1.03 — 3.41, р = 0.04). Conclusion: determination of EFT with echo-cardiogaphy can be used in estimation of AF relapse risk after RFA.
About the Authors
E. L. Zaslavskaya
Pavlov First Saint Petersburg State Medical University;
Federal Almazov North-West Medical Research Centre
Russian Federation
Russian Federation
V. A. Ionin
Pavlov First Saint Petersburg State Medical University;
Federal Almazov North-West Medical Research Centre
Russian Federation
Russian Federation
O. V. Listopad
Pavlov First Saint Petersburg State Medical University;
Federal Almazov North-West Medical Research Centre
Russian Federation
Russian Federation
S. E. Nifontov
Pavlov First Saint Petersburg State Medical University;
Federal Almazov North-West Medical Research Centre
Russian Federation
Russian Federation
K. N. Malikov
Pavlov First Saint Petersburg State Medical University;
Federal Almazov North-West Medical Research Centre
Russian Federation
Russian Federation
A. V. Soboleva
Pavlov First Saint Petersburg State Medical University;
Federal Almazov North-West Medical Research Centre
Russian Federation
Russian Federation
E. I. Baranova
Pavlov First Saint Petersburg State Medical University;
Federal Almazov North-West Medical Research Centre
Russian Federation
Russian Federation
References
1. Ионин В. А., Листопад О. В., Нифонтов С. Е. и др. Галектин 3 у пациентов с метаболическим синдромом и фибрилляцией предсердий // Артериальная гипертензия. — 2014.— Т. 20. — № 5. — С. 101 — 108.
2. Листопад О. В., Баженова Е. А., Ионин В. А. и др. Толщина эпикардиального жира и сосудистая жесткость у больных абдоминальным ожирением: гендерные особенности // Проблемы женского здоровья. — 2015. — Т. 10. — № 1. — С. 43 — 49.
3. Anderson J. L., Halperin J. L. et al. Management of patients with atrial fibrillation (Compilation of 2006 ACCF/AHA/ESC and 2011 ACCF/AHA/HRS Recommendations) // Circulation. — 2013. —Vol. 127. — P. 1916—1926.
4. Calkins H., Kuck K. H., Cappato R. et al. HRS/EHRA/ ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design // Journ. of Interventional Cardiac Electrophysiology. — 2012. — Vol. 33. — № 2. — P. 171 — 257.
5. Camm A. J., Lip G. Y., De Caterina R. et al. Focused update of the ESC Guidelines for the management of atrial fibrillation // Eur. Heart Journ. — 2012. — Vol. 33. — P. 2719 — 2747.
6. Chamberlain A. M., Agarwal S. K., Ambrose M. et al. Metabolic syndrome and incidence of atrial fibrillation among blacks and whites in the Atherosclerosis Risk in Communities Study // Am. Heart J. — 2010. — Vol. 159. — P. 159— 164.
7. Chen L. Y., Sotoodehnia N., Buzkova P. et al. Atrial fibrillation and the risk of sudden cardiac death: the atherosclerosis risk in communities study and cardiovascular health study // JAMA Internal Medicine. — 2013. — Vol. 173. — P. 29 — 35.
8. Lau D. H., Schotten U., Mahajan R. et al. Novel mechanisms in the pathogenesis of atrial fibrillation: practical applications // Eur. Heart Journ. — 2016. — Vol. 37. — P. 1573—1581.
9. Lloyd-Jones D. M., Wang T. J., Leip E. P. et al. Lifetime risk for development of atrial fibrillation the Framingham Heart Study // Circulation. — 2004. — Vol. 110. — P. 1046—1046.
10. Mohanty S., Mohanty P., Di Biase L. et al. Impact of metabolic syndrome on procedural outcomes in patients with atrial fibrillation undergoing catheter ablation // Journ. of the Am. — 2012. — Vol. 59. — № 14.
11. Nalliah C. J., Sanders P., Kottkamp H. et al. The role of obesity in atrial fibrillation // Eur. Heart Journ. — 2016. — Vol. 37. — P. 1565— 1572.
12. Noheria A., Kumar A., Wylie J. R. et al. Catheter ablation vs antiarrhythmic drug therapy for atrial fibrillation // Archives of Internal Medicine Journal. — 2008. —Vol. 168. — № 6. — P. 581—586.
13. Pandit S. V., Anumonwo J., Jalife J. Atrial fibrillation susceptibility in obesity: an excess adiposity and fibrosis comp¬licity? // Circulation research. — 2016. — Vol. 118. — P. 1468—1471.
Review
For citations:
Zaslavskaya E.L., Ionin V.A., Listopad O.V., Nifontov S.E., Malikov K.N., Soboleva A.V., Baranova E.I. Efficiency of radiofrequency ablation of pulmonary vein ostium for patients with atrial fibrillation and metabolics. The Scientific Notes of the Pavlov University. 2016;23(2):39-42. (In Russ.)
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