Impact of Tricuspid Regurgitation on Atrial Fibrillation Recurrence After Pulmonary Vein Isolation.

IF 2.3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Sebastian Weyand, Viola Adam, Paloma Biehler, Patricia Hägele, Simon Hanger, Stephanie Löbig, Andrei Pinchuk, Felix Ausbuettel, Christian Waechter, Peter Seizer
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引用次数: 0

Abstract

Background: The impact of tricuspid regurgitation (TR) on the outcomes of pulmonary vein isolation (PVI) for atrial fibrillation (AF) remains unclear. While the effects of mitral regurgitation (MR) on PVI outcomes are well-documented, there are limited data on how moderate or greater TR influences PVI efficacy and recurrence rates.

Objectives: The aim of this study was to assess the impact of moderate or greater TR on the outcomes of PVI, particularly focusing on AF recurrence rates within the first year post-PVI.

Methods: We conducted an observational cohort study involving 421 patients undergoing their first PVI. 96 patients with moderate or greater TR were propensity score-matched with 96 controls based on age, sex, body mass index, and MR severity. Procedural parameters, complication rates, and AF recurrence within 1-year post-PVI were analyzed.

Results: Despite comparable procedural parameters and low overall complication rates between the groups, patients with moderate or greater TR experienced significantly higher AF recurrence rates within the first year after PVI. Right atrium (RA) area was notably larger in these patients, suggesting a potential link between RA remodeling and increased AF recurrence.

Conclusions: Our findings indicate that moderate or greater TR is associated with higher recurrence rates of AF after PVI, potentially due to RA enlargement and remodeling. This highlights the need for tailored ablation strategies that consider the RA substrate and/or TR treatment in patients with significant TR and AF. Further multicenter, prospective studies are required to validate these results and explore long-term outcomes.

背景:三尖瓣返流(TR)对房颤(AF)患者肺静脉隔离(PVI)结果的影响尚不清楚。虽然二尖瓣返流(MR)对PVI结果的影响有充分的文献记载,但关于中度或重度二尖瓣返流如何影响PVI疗效和复发率的数据有限。目的:本研究的目的是评估中度或较大程度的TR对PVI预后的影响,特别是关注PVI后一年内房颤复发率。方法:我们进行了一项观察性队列研究,涉及421例首次PVI患者。96例中度或重度TR患者根据年龄、性别、体重指数和MR严重程度与96名对照进行倾向评分匹配。分析手术参数、并发症发生率和pvi后1年内房颤复发率。结果:尽管两组间的手术参数比较,总体并发症发生率较低,但中度或较高TR的患者在PVI术后一年内的房颤复发率明显较高。这些患者的右心房(RA)面积明显增大,提示RA重塑与房颤复发增加之间存在潜在联系。结论:我们的研究结果表明,中度或较大的TR与PVI后房颤复发率较高相关,可能是由于RA的扩大和重塑。这突出了考虑RA底物和/或明显TR和AF患者的TR治疗的量身定制消融策略的必要性。需要进一步的多中心前瞻性研究来验证这些结果并探索长期结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.20
自引率
14.80%
发文量
433
审稿时长
3-6 weeks
期刊介绍: Journal of Cardiovascular Electrophysiology (JCE) keeps its readership well informed of the latest developments in the study and management of arrhythmic disorders. Edited by Bradley P. Knight, M.D., and a distinguished international editorial board, JCE is the leading journal devoted to the study of the electrophysiology of the heart.
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