Predictors of Heart Failure Caused by Volume Overload Using an Irrigation Catheter during Catheter Ablation for Atrial Fibrillation

Background: Predictors of heart failure caused by volume overload are unclear. This study to investigate the predictors of heart failure caused by volume overload using an irrigation catheter during atrial fibrillation (AF) ablation. Methods: This study included 431 consecutive patients with AF who underwent ablation in their first session from April 2009 to December 2015. According to right ventricular systolic pressure (RVSP) after AF ablation, patients were divided into high (≥ 40 mmHg, n = 62) or normal RVSP (< 40 mmHg, n = 312) groups. Results: There were significant differences in the rates of age ≥ 65-years-old (53.2% vs. 32.1%), history of congestive heart failure (16.1% vs. 8.0%), hypertension (67.7% vs. 50%), and diabetes mellitus (25.8% vs. 6.4%), as well as serum creatinine concentrations (0.92 vs. 0.83 mg/dl), B-type natriuretic peptide levels (165.9 vs. 109.0 pg/ml), left atrial dimension (44.4 vs. 41.0 mm), mitral inflow E wave velocity before ablation (E wave, 76.6 vs. 70.2 cm/sec), and the total amount of injection (3591 vs. 3282 ml) between the high and normal RVSP groups. There were no significant differences in sex, body mass index, left ventricular ejection fraction, and radiofrequency duration. Age ≥ 65-years-old (p = 0.004), history of diabetes mellitus (p < 0.001), left atrial dimension (p = 0.021), and E wave (p = 0.049) showed significant differences in multiple analysis between the high and normal RVSP groups. Conclusions: Close observation is mandatory with an older age, greater left atrial dimension and mitral E wave, and/or a history of diabetes mellitus to avoid heart failure after AF ablation using irrigation catheters.