Resting and Exercise-Induced Left Atrial Hypertension in Patients With Atrial Fibrillation: The Causes and Implications for Catheter Ablation

JACC. Clinical Electrophysiology
Marek SramkoJosef Kautzner

Abstract

The aim of this paper was to investigate the prevalence of resting and exercise-induced left atrial hypertension (LAH) in patients with nonvalvular atrial fibrillation (AF), association of the LAH with other cardiac abnormalities, and its implications for AF catheter ablation. The clinical role of LAH in patients with established AF is largely unknown. Patients scheduled for catheter ablation of AF (n = 240; age 60 ± 10 years; 67% men, 62% paroxysmal AF) underwent detailed echocardiography, assessment of quality of life (QoL), left atrial (LA) voltage mapping, and measurement of the LA pressure at rest and during isometric handgrip exercise. After ablation they were followed for AF recurrence for 16 ± 6 months. Resting and exercise-induced LAH (mean LA pressure >15 mm Hg) occurred in 15% and 34% of the patients, respectively. Both the patients with resting and exercise-induced LAH had typical features of latent heart failure with preserved ejection fraction associated with advanced LA structural and functional remodeling. AF recurred after ablation in 45% of the patients. LAH was an independent risk factor for arrhythmia recurrence (hazard ratio: 1.7, 95% confidence interval: 1.2 to 2.2). The patients with LAH had worse baselin...Continue Reading

References

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Citations

Dec 22, 2019·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Björn Müller-EdenbornAmir Jadidi
Dec 4, 2020·Journal of Cardiovascular Electrophysiology·Jasen L GilgeParin J Patel
Aug 3, 2021·Frontiers in Physiology·Lisa A GottliebRuben Coronel
Aug 8, 2021·Journal of Clinical Medicine·Massimiliano ManfrinMatthias Unterhuber
Dec 22, 2021·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Maximilian von RoederPhilipp Lurz

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