Delayed recurrence of atrial fibrillation 2 years after catheter ablation is associated with metabolic syndrome

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• 作者：Yong-Soo Baek ; Pil-Sung Yang ; Tae-Hoon Kim ; Jae-Sun Uhm ; Jong-Youn Kim ; Boyoung Joung ; Moon-Hyoung Lee ; Hui-Nam Pak ; ^{hnpak@yuhs.ac" class="auth_mail" title="E-mail the corresponding author}
• 关键词：RFCA ; radiofrequency catheter ablation ; AF ; atrial fibrillation ; BMI ; body mass index ; CR ; clinical recurrence ; CL&le ;   ; 2-years ; clinical recurrence of atrial fibrillation within 2  ; years after radiofrequency catheter ablation ; CL> ;   ; 2-years ; clinical recurrence of atrial fibrillation 2  ; years after radiofrequency catheter ablation ; MS ; metabolic syndrome ; VLCR ; very late clinical recurrence
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：15 November 2016
• 年：2016
• 卷：223
• 期：Complete
• 页码：276-281
• 全文大小：401 K

文摘

Whether delayed clinical recurrence of atrial fibrillation (AF) 2 years after radiofrequency catheter ablation (CR_> 2-years) is related to AF progression remains unclear.

Objective

We hypothesized that metabolic factors are associated with CL_> 2-years.

Methods

Among 1825 patients who underwent catheter ablation, the study included 523 patients with AF recurrence (27.2% women, mean age 57 ± 11 years, 58.3% paroxysmal AF) 3 months after the ablation procedure. They were divided into the clinical recurrence within 2-years (CL_≤ 2-years: AF recurrence at 3–24 months) and CL_> 2-years (AF recurrence > 24 months) groups. Clinical and imaging parameters and polysomnograms were compared.

Results

Over 42 ± 19 months of follow-up, 409 (78.2%) and 114 (21.8%) patients formed the CL_≤ 2-years and CL_> 2-years groups, respectively. The CL_> 2-years group had higher proportions of overweight (p = 0.004), hypertension (p = 0.049), diabetes mellitus (p = 0.037), dyslipidemia (p = 0.009), high sensitivity C-reactive protein > 8 mg/L (p = 0.049), and metabolic syndrome (p = 0.011) than the CL_≤ 2-years group. Despite no significant difference between the apnea and hypopnea indices in the CL_≤ 2-years (n = 97) and CL_> 2-years (n = 28) groups, the minimum peripheral oxygen saturation was significantly lower in the latter than the former (p = 0.032). In the multivariate analysis, overweight (odds ratio [OR] 1.756, 95% confidence interval [CI] 1.146–2.693, p = 0.010), dyslipidemia (OR 1.587, 95% CI 1.033–2.438, p = 0.035), and metabolic syndrome (OR 1.972, 95% CI 1.158–3.356, p = 0.012) were independently associated with CL_> 2-years.

Conclusions

Overweight, dyslipidemia, and metabolic syndrome are independent predictors of CL_> 2-years for AF after catheter ablation. CL_> 2-years seems to be affected by metabolic factors and can be related to AF progression.