Prognostic Implications of Left Atrial Spontaneous Echo Contrast with Catheter Ablation of Nonvalvular Atrial Fibrillation Patients with Left Atrial Dilation
Abstract
:1. Introduction
2. Methods
2.1. Study Population
2.2. Clinical Characteristics
2.3. TEE
2.4. Preparation for the Procedure
2.5. Ablation Procedure
2.6. Follow-Up
2.7. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Procedural Details and Medication Use after the Procedure
3.3. Follow-Up
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | LASEC Group (n = 73) | No LASEC Group (n = 50) | p Value |
---|---|---|---|
Age (years) | 62.6 ± 9.6 | 61.3 ± 8.9 | 0.319 |
Male sex (n, %) | 47 (64.4%) | 40 (80.0%) | 0.062 |
PsAF (n, %) | 72 (98.6%) | 46 (92.0%) | 0.173 |
History of AF (years) | 3.2 ± 2.7 | 3.2 ± 2.9 | 0.779 |
Duration of AF (years) for PsAF | 0.68 ± 0.45 | 0.73 ± 0.55 | 0.971 |
BMI (kg/m2) | 25.4 ± 3.3 | 25.9 ± 2.9 | 0.359 |
DM (n, %) | 14 (19.2%) | 10 (20.0%) | 0.910 |
Hypertension (n, %) | 45 (61.6%) | 37 (74.0%) | 0.153 |
Stroke/TIA | 8 (11.0%) | 4 (8.0%) | 0.815 |
Coronary artery disease (n, %) | 7 (9.6%) | 7 (14.0%) | 0.449 |
Heart failure (n, %) | 18 (24.7%) | 12 (24.0%) | 0.934 |
CHA2DS2-VASc score | 2.3 ± 1.3 | 2.2 ± 1.5 | 0.308 |
Serum creatinine (μmol/L) | 77.3 ± 13.9 | 80.3 ± 15.6 | 0.510 |
GFR (mL/min/1.73 m²) | 84.9 ± 13.8 | 85.9 ± 16.8 | 0.707 |
D-dimers (mg/L) | 0.27 ± 0.16 | 0.24 ± 0.18 | 0.059 |
Homocysteine (μmol/L) | 12.7 ± 3.2 | 12.1 ± 2.7 | 0.554 |
Pro-BNP (pg/mL) | 1088.6 ± 996.1 | 832.8 ± 887.9 | 0.068 |
Troponin I | 0.02 ± 0.04 | 0.02 ± 0.01 | 0.233 |
LAD (mm) | 47.1 ± 2.1 | 46.9 ± 2.0 | 0.598 |
LAV (cm3) | 182.5 ± 43.9 | 172.8 ± 33.2 | 0.224 |
LVEDD (mm) | 50.2 ± 4.6 | 50.4 ± 4.3 | 0.512 |
LVEF (%) | 60.5 ± 8.3 | 61.7 ± 7.8 | 0.360 |
LASEC Group (n = 73) | No LASEC Group (n = 50) | p Value | |
---|---|---|---|
Ablation energy (RFA/CBA) | 53/20 | 33/17 | 0.433 |
Ablation strategy (PVI/PVI + LA roof line) | 39/34 | 31/19 | 0.346 |
Total procedure duration (min) | 125.1 ± 36.7 | 123.6 ± 33.0 | 0.903 |
Left atrial dwell time (min) | 95.6 ± 36.1 | 96.2 ± 31.4 | 0.962 |
Total fluoroscopy time (min) | 9.6 ± 4.2 | 8.8 ± 6.0 | 0.416 |
Radiation dose (μGym2) | 2266.7 ± 1532.2 | 2348.4 ± 1822.6 | 0.655 |
Radiation dose (mGy) | 210.2 ± 135.2 | 220.8 ± 170.3 | 0.518 |
Medication use after procedure | |||
Antiarrhythmic drug (n, %) | 70 (95.9%) | 47 (94.0%) | 0.959 |
Beta-blocker (n, %) | 21 (28.8%) | 17 (34%) | 0.537 |
NOAC (n, %) | 62 (84.9%) | 48 (96%) | 0.239 |
ACEI/ARB (n, %) | 43 (58.9%) | 26 (52.0%) | 0.449 |
No AF/AT Recurrence | With AF/AT Recurrence | |
---|---|---|
LASEC group | 33 (45.2%) | 40 (54.8%) |
No LASEC group | 34 (68.0%) | 16 (32.0%) |
Total Population (n = 123) | Univariate Analysis | Multivariate Analysis | ||||
---|---|---|---|---|---|---|
p | HR | 95% CI | p | HR | 95% CI | |
Age (≥65 vs. <65 years) | 0.611 | 0.872 | 0.516–1.475 | |||
Sex (male vs. female) | 0.621 | 1.161 | 0.642–2.097 | |||
BMI (abnormal vs. normal) | 0.217 | 0.719 | 0.425–1.215 | |||
CHA2DS2-VASc score (>2 vs. ≤2) | 0.932 | 1.023 | 0.603–1.737 | |||
LAD (≥47 vs. <47 mm) | 0.122 | 0.658 | 0.387–1.118 | |||
HF (HF vs. normal) | 0.011 | 0.379 | 0.179–0.802 | 0.008 | 0.359 | 0.168–0.768 |
LAV (≥170 vs. <170 cm3) | 0.025 | 1.859 | 1.082–3.196 | 0.040 | 1.787 | 1.028–3.108 |
History of AF (≥2 vs. <2 years) | 0.003 | 3.005 | 1.471–6.137 | 0.018 | 2.415 | 1.166–5.001 |
LASEC (LASEC vs. no LASEC) | 0.015 | 2.058 | 1.151–3.679 | 0.009 | 0.455 | 0.253–0.819 |
Ablation energy (CBA vs. RFA) | 0.411 | 1.261 | 0.725–2.193 | |||
Ablation strategy (PVI vs. PVI + LA roof line) | 0.905 | 1.035 | 0.590–1.813 |
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Lin, C.; Bao, Y.; Xie, Y.; Wei, Y.; Luo, Q.; Ling, T.; Jin, Q.; Pan, W.; Xie, Y.; Wu, L.; et al. Prognostic Implications of Left Atrial Spontaneous Echo Contrast with Catheter Ablation of Nonvalvular Atrial Fibrillation Patients with Left Atrial Dilation. J. Cardiovasc. Dev. Dis. 2022, 9, 306. https://doi.org/10.3390/jcdd9090306
Lin C, Bao Y, Xie Y, Wei Y, Luo Q, Ling T, Jin Q, Pan W, Xie Y, Wu L, et al. Prognostic Implications of Left Atrial Spontaneous Echo Contrast with Catheter Ablation of Nonvalvular Atrial Fibrillation Patients with Left Atrial Dilation. Journal of Cardiovascular Development and Disease. 2022; 9(9):306. https://doi.org/10.3390/jcdd9090306
Chicago/Turabian StyleLin, Changjian, Yangyang Bao, Yun Xie, Yue Wei, Qingzhi Luo, Tianyou Ling, Qi Jin, Wenqi Pan, Yucai Xie, Liqun Wu, and et al. 2022. "Prognostic Implications of Left Atrial Spontaneous Echo Contrast with Catheter Ablation of Nonvalvular Atrial Fibrillation Patients with Left Atrial Dilation" Journal of Cardiovascular Development and Disease 9, no. 9: 306. https://doi.org/10.3390/jcdd9090306
APA StyleLin, C., Bao, Y., Xie, Y., Wei, Y., Luo, Q., Ling, T., Jin, Q., Pan, W., Xie, Y., Wu, L., & Zhang, N. (2022). Prognostic Implications of Left Atrial Spontaneous Echo Contrast with Catheter Ablation of Nonvalvular Atrial Fibrillation Patients with Left Atrial Dilation. Journal of Cardiovascular Development and Disease, 9(9), 306. https://doi.org/10.3390/jcdd9090306