Efficacy of catheter ablation for atrial fibrillation in patients with significant functional mitral regurgitation.

Content Provider	Europe PMC
Author	Zhao, Danqing Zhang, Futao Liu, Xiaojie Li, Muzhang Zhang, Leiming Hu, Juan Li, Feifei Wu, Jintao
Copyright Year	2023
Abstract	Background:Catheter ablation has been established to be an effective therapy for paroxysmal atrial fibrillation (AF) and is recommended as the treatment of choice for many patients, including those with clinically significant functional mitral regurgitation (MR). However, there is little information available about the clinical efficacy of catheter ablation for paroxysmal AF in patients with significant functional MR.Methods:We performed a retrospective study of 247 patients with paroxysmal AF who underwent AF ablation. The study included 28 (11.3%) patients with significant functional MR and 219 (88.7%) without significant functional MR. AF recurrence was defined as the occurrence of confirmed atrial tachyarrhythmia lasting >30 seconds beyond 3 months after catheter ablation.Results:During a mean follow-up of 20.1 ± 7.4 months (range, 3–36 months), 45 (18.2%) patients developed recurrence of AF. The recurrence rate of AF was higher in patients with significant functional MR than in those without significant functional MR (42.9% vs 15.1%; P < .001). Univariable Cox proportional hazards regression analysis showed that significant functional MR (hazard ratio [HR], 3.46; 95% confidence interval [CI], 1.78–6.72; P < .001), age (HR, 1.04; 95% CI, 1.01–1.08; P = .009), the CHA2DS2-VASc score (HR, 1.28; 95% CI, 1.05–1.56; P = .017), and heart failure (HR, 4.71; 95% CI, 1.85–11.96; P = .001) were associated with the risk of recurrence. Multivariable analysis showed that significant functional MR (HR, 2.48; 95% CI, 1.21–5.05; P = .013), age (HR, 1.04; 95% CI, 1.00–1.07; P = .031), and heart failure (HR, 3.39; 95% CI, 1.27–9.03; P = .015) were independent predictors of AF recurrence.Conclusion:Patients with significant functional MR have an increased risk of AF recurrence after catheter ablation.
ISSN	00257974
Journal	Medicine
Volume Number	102
PubMed Central reference number	PMC9997827
Issue Number	10
PubMed reference number	36897680
e-ISSN	15365964
DOI	10.1097/md.0000000000033231
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2023-03-01
Publisher Place	Hagerstown, MD
Access Restriction	Open
Rights License	This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
Subject Keyword	atrial fibrillation catheter ablation functional mitral regurgitation recurrence
Content Type	Text
Resource Type	Article
Subject	Medicine