Abstract 18994: Endothelial Dysfunction Predicts Atrial Arrhythmia Recurrence Following Pulmonary Vein Isolation in Patients ≤ 60 Years Old
Background: Endothelial dysfunction may be associated with atrial fibrillation (AFib). However, available evidence concerning endothelial dysfunction in patients with AFib undergoing left atrial ablation is limited. The purpose of this study was to investigate whether left atrial ablation for AFib affects endothelial dysfunction, and whether endothelial dysfunction predicts atrial arrhythmia recurrence after catheter ablation.
Methods: We prospectively studied 92 patients (age 57 ± 10 years old, 78% males) who underwent left atrial ablation for the treatment of refractory paroxysmal or persistent AFib. Endothelial function was non-invasively evaluated before and at 3 months after ablation, using reactive hyperemia-peripheral arterial tonometry (RH-PAT). Logarithmic value of RH-PAT index (Ln_RHI) was calculated accordingly. Patients were followed for 3 months for atrial arrhythmia recurrence, and the optimal cut-off value of Ln_RHI to predict it was defined by Youden index.
Results: Left atrial ablation for AFib had no significant effect on endothelial function (Baseline Ln_RHI; 0.62, follow-up Ln_RHI; 0.65, mean difference [standard error] 0.029 [0.035], p=0.41). Among the entire study subjects, baseline Ln_RHI value did not predict atrial arrhythmia
recurrence: However in subgroup analysis of patients aged ≤ 60 years (n=56), lower baseline Ln_RHI (≤ 0.65) predicted atrial arrhythmia recurrence even after adjustment for propensity score (hazard ratio [95% confidence interval] for Ln_RHI ≤ 0.65 4.30 [1.11 to 28.3], p=0.03). In Kaplan-Meier analysis, patients with lower endothelial function had significantly higher rate of atrial arrhythmia recurrence (Figure).
Conclusion: Among patients aged ≤ 60 years, endothelial dysfunction prior to left atrial ablation for AFib was significantly associated with increased risk of atrial arrhythmia recurrence.
Author Disclosures: Y. Matsuzawa: None. M. Suleiman: None. R.R. Guddeti: None. T. Kwon: None. D.O. Hodge: None. L.O. Lerman: None. P.A. Friedman: None. A. Lerman: None.
- © 2014 by American Heart Association, Inc.