Abstract 13730: A High BNP Level Precipitates an Improvement in Exercise Tolerance after a Successful Catheter Ablation of Persistent Atrial Fibrillation
Introduction: Atrial fibrillation (AF) has a negative hemodynamic effect that can lead to a decreased exercise tolerance and fatigability on exertion. However, it is unclear whether restoration of sinus rhythm by catheter ablation of AF improves the exercise tolerance. The purpose of this study was to investigate the exercise tolerance quantitatively by comparing that before and after catheter ablation of AF.
Hypothesis: We assessed the hypothesis that exercise tolerance can improve with sinus rhythm restoration by catheter ablation of persistent AF.
Methods: This study included 55 consecutive patients who underwent catheter ablation of persistent AF (57.4±1.0 y/o, 51 males, AF duration 2.4±0.3 years). The exercise tolerance determined by cardiopulmonary exercise testing was compared between that prior to, and 3 months after the catheter ablation.
Results: Sinus rhythm was maintained in 46 patients (84%) over a 3-month follow-up (SR patients), including 20 on oral antiarrhythmic drugs. In the SR patients, the baseline peak oxygen uptake (peak VO2) and VE-VCO2 slope were 26.2±0.9 ml/kg/min and 27.0±0.6, respectively. The peak VO2 at 3 months increased significantly (28.6±0.8 ml/kg/min (P<0.001); paired t test), and VE-VCO2 decreased significantly (25.9±0.4 ml/kg/min (P<0.001); paired t test). These favorable changes were not observed in the remaining 9 patients with persisted AF after the catheter ablation. The improvement rate of the peak VO2 in the SR patients exhibited a positive correlation to the baseline BNP (R=0.59 P<0.001), but not to the age, body mass index, AF duration, resting heart rate, and left atrial volume. Furthermore, when responders were defined as patients whose peak VO2 improved after the AF ablation, the logistic regression analysis revealed the baseline BNP as an independent predictor of a responder (odds ratio 1.032; 95% con[[Unable to Display Character: ﬁ]]dence interval 1.007-1.072; P=0.004).
Conclusions: The elimination of persistent AF by catheter ablation was associated with an improvement in the exercise tolerance by 3 months after the catheter ablation. This was particularly true in patients with high BNP values at baseline.
Author Disclosures: Y. Katsumata: None. S. Takatsuki: None. T. Nishiyama: None. T. Kimura: None. N. Nishiyama: None. Y. Tanimoto: None. K. Tanimoto: None. Y. Aizawa: None. K. Fukuda: None.
- © 2014 by American Heart Association, Inc.