Prediction of mitral regurgitation severity one year after successful catheter ablation for lone long-standing atrial fibrillation

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  • 孤立性長期心房細動に対するカテーテルアブレーション治療が成功してから1年後の僧帽弁逆流の重症度予測

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Abstract

<p>Background: Long-standing atrial fibrillation (LSAF) is a risk factor for mitral regurgitation (MR). Conversion to sinus rhythm can be achieved by radiofrequency catheter ablation (RFCA), which is also expected to reduce the severity of MR through reverse remodeling of the left atrium (LA) and the mitral apparatus. However, the severity of MR one year after RFCA is often unpredictable. Methods: To create an appropriate model for the prediction of MR severity one year after successful RFCA, we assessed 50 patients with lone LSAF by transthoracic two-dimensional echocardiography prior to RFCA and one month and one year after RFCA. On the basis of the data obtained from the assessments, three prediction models for MR one year after RFCA were specified and analyzed using multivariate linear regression. Results: A prediction model for MR using variables, such as LA volume index and MR severity in pre-RFCA, and left ventricular ejection fraction, MR severity, and the ratio of the diameter of the anteroposterior annulus to that of the transverse mitral annulus one month after RFCA, best matched the demonstrated MR severity one year after RFCA (sensitivity, 1.00; specificity, 0.795). Excellent relationships between the predicted MR severity and the demonstrated MR severity (r = 0.732) and between changes in the demonstrated MR severity and changes in the predicted MR severity were found.</p>

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