Open AccessRadiofrequency catheter ablation is effective for atrial fibrillation patients with hypertrophic cardiomyopathy by decreasing left atrial pressure
Author(s) -
Ikenaga Hiroki,
Nakano Yukiko,
Oda Noboru,
Suenari Kazuyoshi,
Sairaku Akinori,
Tokuyama Takehito,
Kawazoe Hiroshi,
Matsumura Hiroya,
Tomomori Shunsuke,
Kihara Yasuki
Publication year - 2017
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/j.joa.2016.08.006
Subject(s) - medicine , cardiology , atrial fibrillation , hypertrophic cardiomyopathy , catheter ablation , radiofrequency catheter ablation , left atrial pressure , radiofrequency ablation , ablation , blood pressure
Background Radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) refractory to medical therapy remains controversial in patients with hypertrophic cardiomyopathy (HCM); the acute effects on the direct left atrial (LA) pressure are not completely understood. Methods We consecutively studied patients with HCM ( n =15) and without HCM (NHCM, n =106) who underwent extensive encircling pulmonary vein isolation for drug‐refractory AF. We compared clinical parameters, echocardiographic parameters, electrophysiological parameters, LA pressures using hemodynamic catheterization and recurrence rate in both groups. Results The LA volume index was significantly higher (51.9±13.6 mL/m 2 vs. 41.6±12.7 mL/m 2 , p =0.02) in the HCM group than the NHCM group. The pre‐ablation mean LA pressure was significantly higher in the HCM group than the NHCM group. Among the AF patients, the mean LA pressure decreased more significantly in the HCM group than the NHCM group (post‐ablation minus pre‐ablation pressures: 4.2±3.7 mmHg vs. 0.9±4.1 mmHg, p= 0.03). The early recurrence rate (within 30 days after ablation) tended to be higher in the HCM group than the NHCM group (20% vs. 5.7%, p =0.08), but the rates of late recurrences (>30 days after ablation) were similar (13.3% vs. 7.6%, p =0.83). Discontinuation of antiarrhythmic drugs occurred at rates of 13% and 62% in the HCM and NHCM groups, respectively ( p <0.001). Conclusions The LA pressure in the HCM group decreased immediately after AF RFCA. Patients with HCM and drug‐refractory AF may benefit from RFCA.