Left atrial functions in long term after catheter ablation of premature ventricular complexes

OBJECTIVE

Premature ventricular complex (PVC) ablation has been shown to improve left ventricle (LV) diastolic function and left atrial (LA) reverse modeling, especially in the short term. In the present study, PVC ablation via radiofrequency catheter (RFCA) was evaluated with respect to its long-term effects on LA size and dynamic functions.

PATIENTS AND METHODS

A total of 71 patients (age 43.49±12.8 years, 37 men [52%]) with high-burden (21% mean burden) PVCs who were treated with RFCA were included in this retrospective study. The effects of RFCA on three characteristics - LV systolic functions, LV diastolic dysfunctions and mechanical effects pertaining to the LA - were examined by echocardiography at baseline and at 3 months and 18 months after the procedure.

RESULTS

Advancement in LV ejection fraction (LVEF) was seen on long-term follow-up (LVEF baseline 53.01; 3rd month 54.55; 18th month 58.02; p<0.001). LA function gradually improved after RFCA. The LA volume index was significantly decreased after RFCA (baseline 18.15±2.89; 3 months 17.11±2.71; 18 months 16.67±2.61; p<0.001). The LA passive emptying fraction was still increasing over long-term follow-up (baseline 33.33; 3rd month 37.11; 18th month 40.91; p<0.001).

CONCLUSIONS

In the present study, in patients with or without apparent cardiomyopathy, RFCA was shown to successfully eliminate PVCs and improve LA functions in the long term.

Association of epicardial fat thickness with TIMI risk score in NSTEMI/USAP patients

BACKGROUND

The association of epicardial adipose tissue (EAT) with coronary artery disease has been shown in previous studies. Furthermore, the relationship between EAT and acute coronary syndrome was studied recently. Herein, we investigated the relationship between EAT thickness and the thrombolysis in myocardial infarction (TIMI) risk score for non-ST-elevation myocardial infarction (NSTEMI) and unstable angina pectoris (USAP).

PATIENTS AND METHODS

The study included 144 patients with NSTEMI/USAP. The study population was divided into two subgroups according to TIMI risk scores as group I (≤ 4, n = 86) and group II (> 4, n = 58). Stepwise multivariable logistic regression analysis was used to assess the independent association of clinical parameters with TIMI risk score.

RESULTS

EAT thickness was higher in group II than in group I (8.2 ± 2.1 vs. 6.2 ± 2.2, p < 0.001). Moreover, patients in group II had higher rates of multivessel disease and Gensini score (p < 0.001). In univariate linear regression analysis, EAT was positively correlated with TIMI risk score and Gensini score. Multivariate regression analysis showed that EAT thickness (OR: 1.56, 95 % CI: 1.17-2.08, p = 0.003), LVEF (OR: 0.93, 95 % CI: 0.85-0.98, p = 0.03), and Gensini score (OR: 1.36, 95 % CI: 1.24-1.98, p = 0.002) were independently associated with a higher TIMI risk score.

CONCLUSION

In conclusion, EAT thickness is independently associated with TIMI risk score and may be an emerging risk factor for adverse events in NSTEMI/USAP patients.