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Yano M, Egami Y, Kawanami S, Ukita K, Kawamura A, Yasumoto K, Tsuda M, Okamoto N, Matsunaga-Lee Y, Nishino M. Comparison of Postprocedural P-Wave Vector Magnitude on 12-Lead Electrocardiogram Between Cryoballoon and Radiofrequency Ablation. Am J Cardiol 2024; 220:1-8. [PMID: 38522652 DOI: 10.1016/j.amjcard.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/14/2024] [Accepted: 03/11/2024] [Indexed: 03/26/2024]
Abstract
Pulmonary vein isolation (PVI) causes changes in P-wave parameters. However, the difference in changes in P-wave parameters including P-wave vector magnitude (Pvm) between radiofrequency catheter ablation (RFCA) and cryoballoon ablation (CBA) remains unknown. Paroxysmal atrial fibrillation (PAF) patients who underwent only PVI were enrolled. Pvm was calculated by the square root of the sum of the squared P-wave amplitude in leads II and V6 and one-half of the P-wave amplitude in V2. The patients were divided into 2 groups: RFCA and CBA. ΔPvm was calculated as ΔPvm (mV) = (Pvm at pre-PVI)-(Pvm at post-PVI). The following factors were evaluated: (1) differences in the ΔPvm between the 2 groups, (2) relation between late arrhythmia recurrence and ΔPvm in RFCA and CBA groups, and (3) the impact of relevant factors on ΔPvm. The study population included a total of 426 patients with PAF (RFCA, 167 patients; CBA, 259 patients). ΔPvm was significantly larger in CBA than in RFCA (p <0.001). Kaplan-Meier analysis showed late arrhythmia recurrence was significantly higher in patients with low ΔPvm (<0.019 mV) than high ΔPvm (≥0.019 mV) in RFCA (Log-rank p <0.001), and low ΔPvm (<0.033 mV) than high ΔPvm (≥0.033 mV) in CBA (Log-rank p <0.001). Multiple regression analysis showed that CBA and heart rate change were independently and significantly associated with ΔPvm (p <0.001 and p <0.001, respectively). In conclusion, ΔPvm was significantly larger in CBA than RFCA during procedure. Low ΔPvm had a higher risk of late arrhythmia recurrence in RFCA and CBA.
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Affiliation(s)
- Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Yasuyuki Egami
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Shodai Kawanami
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Kohei Ukita
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Akito Kawamura
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Koji Yasumoto
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Masaki Tsuda
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Naotaka Okamoto
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | | | - Masami Nishino
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan.
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Makita T, Kuwahara T, Takahashi K, Nakagawa H, Nabuchi A, Ito Y, Oyagi Y, Kadono K, Oshio T, Takahashi R. Dual linear lesions for right atrial flutter after mitral valve surgery via the superior transseptal approach. J Interv Card Electrophysiol 2024; 67:579-587. [PMID: 37688692 DOI: 10.1007/s10840-023-01631-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 08/28/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND The superior transseptal approach (STA) for mitral valve surgery is associated with a higher risk of developing macroreentrant incisional atrial flutter (AFL) than the left atrial approach. This study aimed to describe the linear lesions for the complex AFL circuit after the STA and to propose an option for the linear ablation target site. METHODS Of the 26 patients who underwent radiofrequency catheter ablation for AFL after mitral valve surgery, data from seven patients with STA incisions were retrospectively analyzed. RESULTS All patients who had undergone the STA had incisional AFL rotated in a long loop within the right atrium (RA) and cavo-tricuspid isthmus (CTI)-dependent AFL. The linear lesions were created in the CTI, the superior RA vestibule, and between the RA-free wall incision or the septal incision and the inferior vena cava. Procedural success was achieved with dual linear lesions in the CTI and superior RA vestibule. Two of seven patients had AFL recurrence during a mean observation period of 22.5 ± 16.7 months. The circuits of recurrent AFL were CTI-dependent AFL and perimitral AFL, respectively. No AFL recurrence was noted with reconduction of the superior RA vestibular lesion. CONCLUSION Dual linear lesions in the CTI and superior RA vestibule are an effective treatment option for RA macroreentrant AFL after the STA.
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Affiliation(s)
- Toshio Makita
- Department of Cardiology, Tokyo Heart Rhythm Clinic, 3-20-1, Kasuya, Setagaya-Ku, Tokyo, 157-0063, Japan.
| | - Taishi Kuwahara
- Department of Cardiology, Tokyo Heart Rhythm Clinic, 3-20-1, Kasuya, Setagaya-Ku, Tokyo, 157-0063, Japan
| | - Kenta Takahashi
- Department of Cardiology, Tokyo Heart Rhythm Clinic, 3-20-1, Kasuya, Setagaya-Ku, Tokyo, 157-0063, Japan
| | - Hirofumi Nakagawa
- Department of Cardiovascular Surgery, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-Ku, Yokohama, Kanagawa, 224-8503, Japan
| | - Akihiro Nabuchi
- Department of Cardiovascular Surgery, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-Ku, Yokohama, Kanagawa, 224-8503, Japan
| | - Yayoi Ito
- Department of Clinical Engineering and Nursing, Tokyo Heart Rhythm Clinic, 3-20-1, Kasuya, Setagaya-Ku, Tokyo, 157-0063, Japan
| | - Yoshimi Oyagi
- Department of Clinical Engineering and Nursing, Tokyo Heart Rhythm Clinic, 3-20-1, Kasuya, Setagaya-Ku, Tokyo, 157-0063, Japan
| | - Kenta Kadono
- Department of Clinical Engineering and Nursing, Tokyo Heart Rhythm Clinic, 3-20-1, Kasuya, Setagaya-Ku, Tokyo, 157-0063, Japan
| | - Takuya Oshio
- Department of Clinical Engineering and Nursing, Tokyo Heart Rhythm Clinic, 3-20-1, Kasuya, Setagaya-Ku, Tokyo, 157-0063, Japan
| | - Ryo Takahashi
- Department of Clinical Engineering and Nursing, Tokyo Heart Rhythm Clinic, 3-20-1, Kasuya, Setagaya-Ku, Tokyo, 157-0063, Japan
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Yano M, Egami Y, Kawanami S, Sugae H, Ukita K, Kawamura A, Nakamura H, Yasumoto K, Tsuda M, Okamoto N, Matsunaga-Lee Y, Nishino M, Tanouchi J. Comparison of myocardial injury and inflammation between ablation index-guided and conventional contact force-guided ablation in atrial fibrillation patients. J Interv Card Electrophysiol 2023; 66:2021-2030. [PMID: 37000285 DOI: 10.1007/s10840-023-01536-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/22/2023] [Indexed: 04/01/2023]
Abstract
PURPOSE Ablation index (AI)-guided ablation improves the incidence of arrhythmia recurrence as compared to conventional contact force (CF)-guided ablation. The aim of this study was to elucidate the differences in the biomarkers associated with myocardial injury and inflammation between conventional CF-guided and AI-guided ablation. METHODS Atrial fibrillation (AF) patients who underwent pulmonary vein isolation (PVI) from the Osaka Rosai Atrial Fibrillation ablation (ORAF) registry were enrolled. We divided the patients into two groups: conventional CF-guided PVI (CF group) and AI-guided PVI (AI group). The differences in biomarkers associated with myocardial injury and inflammation, and long-term durability of PVI between the two groups were evaluated. RESULTS This study population included a total of 794 patients (CF-guided, 241 patients; AI-guided, 553 patients). Total application time was significantly shorter, and total application number was significantly smaller in AI than CF group. High-sensitive troponin I (hs-TnI) post-ablation was significantly higher in AI than CF group (p < 0.001), even after taking the total application number and total application time into consideration. No significant differences in inflammatory markers changes from pre- to post-ablation were observed between the two groups. AI-guided ablation was significantly associated with the hs-TnI post-ablation by multiple regression analysis. The PV reconnection ratio was significantly smaller in AI than CF group (p = 0.037). CONCLUSIONS AI-guided ablation had the ability to create larger lesions than CF-guided ablation despite no increase in inflammation and achieved the better PVI durability than that of CF-guided.
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Affiliation(s)
- Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Yasuyuki Egami
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Shodai Kawanami
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Hiroki Sugae
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Kohei Ukita
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Akito Kawamura
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Hitoshi Nakamura
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Koji Yasumoto
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Masaki Tsuda
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Naotaka Okamoto
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Yasuharu Matsunaga-Lee
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Masami Nishino
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan.
| | - Jun Tanouchi
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
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Yano M, Egami Y, Kawanami S, Sugae H, Ukita K, Kawamura A, Nakamura H, Yasumoto K, Tsuda M, Okamoto N, Matsunaga-Lee Y, Nishino M, Tanouchi J. Relationship between pre-procedural non-ischemic ST-segment depression and the clinical outcomes after catheter ablation in persistent atrial fibrillation patients. J Cardiol 2023; 81:456-463. [PMID: 36822545 DOI: 10.1016/j.jjcc.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/18/2023] [Accepted: 02/05/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND ST-segment depression suggests the presence of coronary artery disease (CAD) during sinus rhythm, but the clinical significance, including the outcomes after catheter ablation (CA), in atrial fibrillation (AF) patients remain unknown. METHODS The present study included persistent AF (PerAF) patients from the Osaka Rosai Atrial Fibrillation ablation (ORAF) registry who underwent an initial ablation and had no history of CAD. We assigned the patients based on the presence of ST-segment depression before CA and evaluated the impact of relevant factors on ST-segment depression and the relationship between ST-segment depression, including leads locations (anterior leads, inferior leads, and lateral leads) or depression type (upsloping, horizontal, and downsloping) or the degree of ST-segment depression and late recurrence of AF (LRAF). RESULTS This study population included a total of 551 patients of whom 189 had ST-segment depression. The median follow-up duration was 397 days and LRAF occurred in 195 patients. By multiple regression analysis, diabetes mellitus, hemoglobin, brain natriuretic peptide, left ventricular ejection fraction, and left atrial diameter were significant determinants of ST-segment depression before CA. Kaplan-Meier analysis demonstrated that the patients with ST-segment depression had a significantly greater risk of LRAF than those without (p < 0.001). Multivariate Cox proportional hazards analysis showed ST-segment depression was independently and significantly associated with a higher risk of LRAF (p < 0.001). The patients with ST-segment depression ≥0.15 mV had a significantly higher risk of LRAF than those with ST-segment depression ≥0.15 mV (p < 0.001). No significant differences among the ST-segment depression lead locations and ST-segment depression type were observed. CONCLUSION Non-ischemic ST-segment depression during AF rhythm was significantly associated with LRAF post CA in PerAF patients.
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Affiliation(s)
- Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Yasuyuki Egami
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Shodai Kawanami
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Hiroki Sugae
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Kohei Ukita
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Akito Kawamura
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Hitoshi Nakamura
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Koji Yasumoto
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Masaki Tsuda
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Naotaka Okamoto
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | | | - Masami Nishino
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan.
| | - Jun Tanouchi
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
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Characteristics and Ablation Outcomes of Atrial Tachycardia in Patients with Prior Cardiac Surgery vs. Spontaneous Scars: Where Are the Differences? J Clin Med 2022; 11:jcm11185407. [PMID: 36143054 PMCID: PMC9505833 DOI: 10.3390/jcm11185407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/11/2022] [Accepted: 08/25/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Atrial scars play an important role in atrial tachycardia (AT). They can not only be found in patients with prior cardiac surgery (PCS) but also in patients without PCS or significant structural heart disease, in which case the scar is called a spontaneous scar (SS). This study aims to compare the characteristics, mechanisms and ablation outcomes of AT in patients with PCS and SS. (2) Methods: We retrospectively reviewed electrophysiological and ablative characteristics of ATs in 46 patients with PCS and 18 patients with SS. (3) Results: There were averages of 1.52 and 2.33 ATs per patient in the PCS group and SS group, respectively (p < 0.01). Cavo-tricuspid isthmus dependent atrial flutter (CTI-AFL) was presented in most patients in both groups (93.50% vs. 77.80%, p = 0.17), whereas the SS group had a higher occurrence of scar-mediated reentrant AT (SMAT) and focal AT (FAT) compared with the PCS group (88.90% vs. 39.10%, p < 0.01; 22.2% vs. 2.2%, p < 0.05). There were no significant differences in acute success rate between the two groups, whereas patients with SS had lower long-term success rate (87.0% vs. 61.1%, p < 0.05) and higher occurrence of sinus node dysfunction (SND) (4.3% vs. 22.2%, p < 0.05). (4) Conclusions: CTI-AFL is common in both patients with PCS and SS, and routine CTI ablation is recommended. Compared with patients with PCS, patients with SS have more ATs, especially with higher occurrence of SMAT and FAT, and had a lower long-term success rate and higher incidence of SND.
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Risk factors and Management of Mitral Annular Atrial Flutter After Mitral Valve Surgery. CURRENT CARDIOVASCULAR RISK REPORTS 2022. [DOI: 10.1007/s12170-022-00696-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yano M, Egami Y, Kawanami S, Sugae H, Ukita K, Kawamura A, Nakamura H, Matsuhiro Y, Yasumoto K, Tsuda M, Okamoto N, Matsunaga-Lee Y, Nishino M, Tanouchi J. Impact of cryoballoon contact angle and acute myocardial injury on pulmonary vein reconnection. Heart Vessels 2022; 37:1882-1891. [PMID: 35552483 DOI: 10.1007/s00380-022-02088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/20/2022] [Indexed: 11/24/2022]
Abstract
At present, it remains unclear whether the effect on cryoinjury can be strongly exerted by contact of the balloon with the pulmonary vein (PV) ostium. The present study included 204 paroxysmal atrial fibrillation (PAF) patients who underwent an initial pulmonary vein isolation (PVI) using a cryoballoon from the Osaka Rosai Atrial Fibrillation ablation (ORAF) registry. The total balloon contact angle was measured from the equator line (sum of the angles of the upper side and bottom side in all PVs) under fluoroscopic imaging. The patients were stratified into three tertile groups according to the total balloon contact angle. We evaluated the relationship between the total balloon contact angle and clinical outcomes, including the value of acute myocardial injury marker (high-sensitive cardiac troponin I [hs-TnI]), arrhythmia recurrence, and PV reconnections in the repeated ablation. The total balloon contact angle was significantly associated with the hs-TnI value among the tertile groups (p < 0.001) and a multiple regression analysis showed that the total balloon contact angle significantly correlated with the hs-TnI value (standardized beta-coefficient = 0.572, p < 0.001). The balloon contact angle in PVs with PV reconnections was significantly lower than in those without (p = 0.044), while no significant differences in the recurrence of atrial fibrillation among the tertile groups were observed in the enrolled patients. The total balloon contact angle was significantly associated with the acute myocardial injury marker, hs-TnI. The total balloon contact angle was significantly associated with PV reconnections after cryoballoon ablation in patients who underwent a repeat ablation.
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Affiliation(s)
- Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Yasuyuki Egami
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Shodai Kawanami
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Hiroki Sugae
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Kohei Ukita
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Akito Kawamura
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Hitoshi Nakamura
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Yutaka Matsuhiro
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Koji Yasumoto
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Masaki Tsuda
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Naotaka Okamoto
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Yasuharu Matsunaga-Lee
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Masami Nishino
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan.
| | - Jun Tanouchi
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan
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Yano M, Egami Y, Kawanami S, Sugae H, Ukita K, Kawamura A, Nakamura H, Matsuhiro Y, Yasumoto K, Tsuda M, Okamoto N, Matsunaga-Lee Y, Nishino M, Tanouchi J. Acute myocardial injury after radiofrequency catheter ablation: impact on pulmonary vein reconnection and relevant factors. Heart Vessels 2021; 37:812-820. [PMID: 34668989 DOI: 10.1007/s00380-021-01972-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/15/2021] [Indexed: 11/29/2022]
Abstract
Radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) causes myocardial injury and induces high-sensitive cardiac troponin I (hs-TnI) release into the systemic circulation. Several factors are considered to be associated with myocardial injury after ablation, but few studies showed the relationship between the value of myocardial injury marker after the RFCA and relevant factors. AF patients who underwent primary RFCA were enrolled from the Osaka Rosai Atrial Fibrillation ablation (ORAF) registry. The relationship between hs-TnI after the RFCA and PV reconnection (PVR) was evaluated. The impact of relevant factors, including baseline patient characteristics, detail of procedure on myocardial injury was investigated. This study included 407 patients (median age was 71 years, the ratio of female was 30.7%). Late arrhythmia recurrence was observed in 111 patients (27.3%) and 66 patients were underwent repeated ablation. PVR was observed in 33 patients (50.0%). The hs-TnI level was significantly lower in the patients with PVR than those without PVR (1.150 ng/ml vs 1.921 ng/ml, p = 0.040). Paroxysmal AF and age were significantly associated with acute myocardial injury after the RFCA (standardized beta coefficient = 0.206 and p < 0.001, standardized beta coefficient = - 0.114 and p = 0.043, respectively). The hs-TnI after RFCA was significantly higher in PAF patients than PerAF (p < 0.001), even if application number and total application time were taken into consideration. Acute myocardial injury after RFCA was significantly lower in the patients with PVR than those without PVR. Age and AF type were significantly and strongly associated with acute myocardial injury after the RFCA.
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Affiliation(s)
- Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Yasuyuki Egami
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Syodai Kawanami
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Hiroki Sugae
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Kohei Ukita
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Akito Kawamura
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Hitoshi Nakamura
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Yutaka Matsuhiro
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Koji Yasumoto
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Masaki Tsuda
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Naotaka Okamoto
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Yasuharu Matsunaga-Lee
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Masami Nishino
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan.
| | - Jun Tanouchi
- Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan
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