Measurement of Left Atrial Pressure is a Good Predictor of Freedom From Atrial Fibrillation
| العنوان: | Measurement of Left Atrial Pressure is a Good Predictor of Freedom From Atrial Fibrillation |
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| المؤلفون: | Dirk Vollmann, Joachim Seegers, Christian Sohns, Markus Zabel, Jan M Sohns, Lars Lüthje, Leonard Bergau |
| المصدر: | Indian Pacing and Electrophysiology Journal Indian Pacing and Electrophysiology Journal, Vol 14, Iss 4, Pp 181-193 (2014) |
| بيانات النشر: | Elsevier BV, 2014. |
| سنة النشر: | 2014 |
| مصطلحات موضوعية: | lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, left atrial pressure, 030204 cardiovascular system & hematology, Structural remodeling, Pulmonary vein, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Internal medicine, medicine, atrial fibrillation, Sinus rhythm, 030212 general & internal medicine, remodeling, business.industry, Hazard ratio, Area under the curve, Atrial fibrillation, medicine.disease, Left atrial pressure, predictors, lcsh:RC666-701, Cardiology, pulmonary vein ablation, Original Article, Linear correlation, left atrial volume, Cardiology and Cardiovascular Medicine, business |
| الوصف: | Background It is suggested that an elevated left atrial pressure (LAP) promotes ectopic beats emanating in the pulmonary veins (PVs) and that LAP might be a marker for structural remodeling. This study aimed to identify if the quantification of LAP correlates with structural changes of the LA and may therefore be associated with outcomes following pulmonary vein isolation (PVI). Methods We analysed data from 120 patients, referred to PVI due to drug-refractory atrial fibrillation (AF) (age 63 ± 8; 57% men). The maximum (mLAP) and mean LAP (meLAP) were measured after transseptal puncture. Results and Conclusions Within a mean follow-up of 303 ± 95 days, 60% of the patients maintained in sinus rhythm after the initial procedure and 78% after repeated PVI. Performing univariate Cox-regression analysis, type of AF, LA-volume (LAV), mLAP and the meLAP were significant predictors of recurrence after PVI (p = 0.03; p = 0.001; p = 0.01). In multivariate analysis mLAP > 18 mmHg, LAV > 100 ml and the presence of persistent AF were significant predictors (p = 0.001; p = 0.019; p = 0.017). The mLAP > 18 mmHg was associated with a hazard ratio of 3.8. Analyzing receiver-operator characteristics, the area under the curve for mLAP was 0.75 (p 18 mmHg predicts recurrence with a sensitivity of 77 % and specificity of 60 %. There was a linear correlation between the LAV from MDCT and mLAP (p = 0.01, R2 = 0.61). The mLAP measured invasively displays a significant predictor for AF recurrence after PVI. There is a good correlation between LAP and LAV and both factors may be useful to quantify LA remodeling. |
| تدمد: | 0972-6292 |
| DOI: | 10.1016/s0972-6292(16)30774-4 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e06b6e0e846af6b93e04040b835421ab https://doi.org/10.1016/s0972-6292(16)30774-4 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....e06b6e0e846af6b93e04040b835421ab |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 09726292 |
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| DOI: | 10.1016/s0972-6292(16)30774-4 |