Abstract 17180: Impact of Sinus Rhythm Maintenance on Exercise Tolerance After Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation
Background: Although catheter ablation is widely used to maintain sinus rhythm and improve symptoms in patients with paroxysmal atrial fibrillation (PAF), it remains to be elucidated whether the ablation could also improve exercise tolerance (ET) in those patients.
Methods: In the first protocol, we enrolled 60 consecutive patients with PAF who underwent the ablation from 2013 September to 2015 June in our hospital (mean age, 62.3±10.2 year-old, M/F 50/10) and thereafter had no recurrence of AF for 6 months. We examined cardiopulmonary exercise test before (baseline) and 6 months after ablation (follow-up) in order to examine the impacts of sinus rhythm maintenance by AF ablation on ET.
Results: Baseline peak VO2 was significantly lower in patients with a longer PAF history (>1 year, n=32) compared with those with a shorter history (<1 year, n=28) (18.4±0.99 vs 21.4±0.93, P<0.05). Importantly, the maintenance of sinus rhythm by AF ablation significantly improved peak VO2, AT and LA-2D volume at follow-up (Table). In the second protocol, we also examined the predictive factors for AF recurrence after 6 months of AF ablation. Among the 60 patients, 15 had AF recurrence, while the remaining 45 had no AF recurrence. Multivariable analysis revealed that VE/VCO2 slope (HR, 4.48; 95% CI: 1.22-28.8, P<0.05) and resting hear rate (HR, 3.37; 95% CI: 1.17-10.3, P<0.05) at baseline were predictive factors for recurrence of AF after 6 months of the ablation. When using the cutoff point measured by ROC curve (27.8 VE/VCO2 slope), the patients with the slope greater than the cutoff point (n=35) had more AF recurrence compared with those with the slope below the point (n=25) (Figure).
Conclusions: These results indicate that ET is reduced in PAF patients with a long duration, which can be improved with sinus rhythm maintenance by AF ablation and that ET before ablation may influence AF recurrence after ablation.
Author Disclosures: K. Fukasawa: None. K. Fukuda: None. M. Nakano: None. Y. Hasebe: None. Y. Kimura: None. T. Chiba: None. K. Miki: None. H. Shimokawa: Speakers Bureau; Modest; Daiichi-Sankyo, Bayer Yakuhin.
- © 2016 by American Heart Association, Inc.