Abstract 13793: Role of Cardiac Autoantibodies for the Prediction of Recurrence Following Cryoballoon-based Lone Atrial Fibrillation Ablation

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Muhammed U Yalcin ◽  
Kadri M Gurses ◽  
Duygu Kocyigit ◽  
Sacit A Kesikli ◽  
Hikmet Yorgun ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Predictive Value ◽  
Cox Regression ◽  
Muscarinic Acetylcholine Receptor ◽  
Left Atrial Volume ◽  
Volume Index ◽  
Lone Atrial Fibrillation ◽  
Left Atrial Volume Index ◽  
One Year ◽  
Af Recurrence

Introduction: Recent evidence have suggested that autoantibodies may play an important role in the development of atrial fibrillation (AF). Predictive value of pre-procedural autoantibodies against beta-1 adrenergic receptor (anti-β1-R) and M2-muscarinic acetylcholine receptor (anti-M2-R) for AF recurrence following cryoballoon-based pulmonary vein isolation (PVI) is still unclear. We aimed to determine the predictive value of pre-procedural anti-β1-R and anti-M2-R levels for AF recurrence in lone AF patients following cryoballoon-based PVI. METHODS: 80 patients (mean age 54.25±7.7 years; 40% males) with lone AF who underwent cryoballoon-based PVI were included in the study. Pre-procedural anti-M2-R and anti-β1-R levels were measured with ELISA. RESULTS: At one-year follow-up after ablation, late AF recurrence was observed in 17 (21.25%) patients. In the Cox regression model including number of antiarrhythmic drugs, early AF recurrence, anti-β1-R levels >159.88 ng/mL, anti-M2-R levels >277.65 ng/mL, AF duration and left atrial volume index; only anti-β1-R levels >159.88 ng/mL (HR: 4.281, p=0.039) and anti-M2-R levels >277.65 ng/mL (HR: 4.313, p=0.030) were found to be independent predictors of late AF recurrence. Anti-β1-R level >159.88 ng/mL was shown to predict late AF recurrence with a sensitivity of 70.59% and specificity of 90.48%. A cut-off value of 277.65 ng/mL for anti-M2-R level predicted AF recurrence with a sensitivity of 70.59% and specificity of 95.24%. CONCLUSION: Pre-procedural serum anti-β1-R and anti-M2-R levels are independent predictors of late AF recurrence following cryoballoon-based PVI in lone AF patients. Detection of pre-procedural anti-β1-R and anti-M2-R levels may serve as a novel method for determination of lone AF patients who may not benefit from cryoballoon-based PVI.

scholarly journals Technical and procedural comparison of two different cryoballoon ablation systems in patients with atrial fibrillation

2021 ◽  
Author(s):  
Sven Knecht ◽  
Christian Sticherling ◽  
Laurent Roten ◽  
Patrick Badertscher ◽  
Laurève Chollet ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial Volume ◽  
Median Number ◽  
Volume Index ◽  
Group Differences ◽  
Cryoballoon Ablation ◽  
Left Atrial Volume Index ◽  
Ice Cap ◽  
Total Procedure Time ◽  
Catheter Design

Abstract Purpose The aim was to report procedural and technical differences of a novel cryoballoon (NCB) ablation catheter for pulmonary vein isolation (PVI) compared to the standard cryoballoon (SCB) catheter. Methods Consecutive patients with atrial fibrillation (AF) undergoing PVI using the NCB and the SCB were included. Procedural parameters, technical differences, acute efficacy, and safety are reported. Results Eighty patients (age 66 ± 10 years, ejection fraction 57 ± 10%, left atrial volume index 40 ± 6 ml/m2) were studied. With the NCB, 156 of 158 PVs (99%) were isolated compared to isolation of 159 of 159 PVs (100%) with the SCB. The median number of freezes in the NCB and the SCB group was 6 (IQR 5–8) and 5 (IQR 4–7), respectively (p = 0.051), with 73% and 71% of the PVs isolated with a single freeze, respectively. Nadir temperature and temperature at isolation were − 59 ± 6 °C and − 45 ± 17 °C in the NCB group and − 46 ± 7 °C and − 32 ± 23 °C in the SCB group, respectively (both p < 0.001) with no difference in time to isolation (TTI). Procedural differences were observed for the total procedure time (84 ± 29 min in the NCB group and 65 ± 17 min in the SCB group, p = 0.003). There was a peri-procedural stroke in one patient in the NCB group. Differences in catheter design were observed that may account for the differences in temperature recordings and ice cap formation. Conclusions Acute efficacy and TTI were similar with the NCB compared to the SCB. Measured temperatures were lower with the NCB, most likely due to differences in catheter design.

Abstract 15257: Epicardial and Peri-atrial Fat Attenuation Predict Recurrence in Patients Undergoing Repeat Catheter Ablation for Refractory Atrial Fibrillation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mark S Brahier ◽  
Fengwei Zou ◽  
Frank Migliarese ◽  
Milos Tomovic ◽  
Alexandra Taylor ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Logistic Regression ◽  
Adipose Tissue ◽  
Catheter Ablation ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Epicardial Fat ◽  
Volume Index ◽  
Atrial Volume ◽  
Af Recurrence

Background: Identifying factors predictive of atrial fibrillation (AF) recurrence after catheter ablation (CA) can improve patient selection. It has been hypothesized that inflammatory paracrine signaling by metabolically active adipose tissue induces pathologic changes in surrounding cardiovascular tissue. In fact, fat attenuation on CT has been previously associated with AF recurrence after de novo CA. The purpose of this study was to investigate the predictive qualities of epicardial and peri-atrial adipose tissue in a population undergoing repeat CA. We hypothesized that higher epicardial and left peri-atrial fat attenuation would predict recurrence as markers of increased localized inflammation. Methods: The study population consisted of 84 patients with symptomatic, drug and ablation-refractory AF undergoing repeat CA. All patients had a pre-ablation, contrast-enhanced cardiac CT, which was analyzed for mean fat attenuation in Hounsfield units (HU) and left atrial volume using the post-processing program 3D Slicer. Patients were followed for recurrence of atrial tachyarrhythmias after a 3-month blanking period. We performed logistic regression to adjust for age, sex, BMI, hypertension, smoking history, diabetes, obstructive sleep apnea, and left atrial volume index. Results: Repeat CA patients with recurrence (n=52) had a higher epicardial fat attenuation (-84.8 ±5.6 vs -88.1 ±5.2 HU; p=0.009) and peri-atrial fat attenuation (-81.0 ±4.7 vs -83.2 ±4.3 HU; p=0.036) than those without recurrence (n=32) at a mean follow-up period of 26 ±18 months. Logistic regression analysis showed that epicardial fat attenuation (OR 1.21; p=0.005) and peri-atrial fat attenuation (OR 1.27; p=0.007) are predictive of AF recurrence independent of traditional risk factors. Conclusions: Epicardial and left peri-atrial adipose attenuation are predictive of recurrence in patients undergoing repeat CA for AF.

Abstract 13956: Cystatin C Based Estimated Glomerular Filtration Rate is a Feasible Parameter for Incident Stroke in Patients With Atrial Fibrillation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Naoto Hashimoto ◽  
Satoshi Nishiyama ◽  
Tetsu Watanabe ◽  
Masahiro Wanezaki ◽  
Gensai Yamaura ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cystatin C ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Left Atrial Volume ◽  
Atrial Appendage ◽  
Volume Index ◽  
Chads2 Score ◽  
Left Atrial Volume Index ◽  
Ckd Stage

Introduction: Chronic kidney disease (CKD) is an important risk factor of stroke in patients with atrial fibrillation (AF). Since AF patients with high CHADS2 score are likely to be old and have history of TIA or stroke, there could be patients who have sarcopenia. Cystatin C based estimated glomerular filtrarion rate (eGFRcys) is less affected by age, gender and muscle mass compared to creatine based eGFR (eGFRcr). We investigated whether eGFRcys is more closely associated with incident stroke in AF patients compared to eGFRcr. Methods: We performed transthoracic and transesophageal echocardiography and measured eGFRcys and eGFRcr in 349 patients with paroxysmal AF and chronic AF (256 males, 64.4 ± 11.7 years). We excluded those who had severe valvular heart disease and end stage renal desease. There were 42 patients with stroke history. Results: eGFRcys showed better correlation with left atrial volume index, levels of brain natriuretic peptide, von Willebrand factor, and left atrial appendage emptying flow velocity, than eGFRcr. eGFRcys was decreased with increading CHADS2 and CHA2DS2VASc score. Patients with left atrial appendage and/or spontaneous echo contrast had a significantly lower eGFRcys compared to those without. The proportion of patients with stroke was increased with advancing CKD stage in eGFRcys. Although eGFRcys and eGFRcr were associated with stroke in logistic regression analysis, eGFRcys but not eGFRcr was an independent predictor for stroke after adjustment for CHADS2 score. Conclusion: eGFRcys is a feasible parameter for incident stroke in AF patients.

Abstract 18551: Predictors of Heart Failure and Death in a High Risk Diabetic Population: The DAVID-Berg Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Mauro Gori ◽  
Paolo Canova ◽  
Alice Calabrese ◽  
Giovanni Cioffi ◽  
Attilio Iacovoni ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Clinical Data ◽  
Cox Regression ◽  
Left Atrial Volume ◽  
Volume Index ◽  
Forward Selection ◽  
Left Atrial Volume Index ◽  
Diabetic Population

Introduction: Diabetic subjects are at high risk of heart failure (HF) and death. Few data are available on the predictive value of NTproBNP, ECG, and echocardiogram in this population Hypothesis: A screening strategy with NTproBNP, ECG, and echo may improve prediction of HF/death events in a diabetic population in HF-stages A & B, beyond clinical data Methods: In 2008, among 4047 subjects aged >55 and <80 yrs treated by three general medicine group practices, the DAVID-Berg study enrolled all subjects with diabetes &/or hypertension &/or cardiovascular disease, without history/symptoms/signs of HF (n=623). Subjects underwent clinical visit, 12-lead ECG, echocardiogram, NTproBNP point of care testing. Recently data on HF/death events have been prospectively collected for all diabetic subjects included in the study (n=198) Results: Median age of the study population was 69 yrs, 62% were men, mostly hypertensive (86%) with known cardiovascular disease (44%). During a median follow-up of 5.2 [4.9,5.5] yrs there were 45 HF/death. At Cox regression analyses univariate predictors of events were known cardiovascular disease, insulin therapy, chronic kidney dysfunction (CKD), NTproBNP≥300 pg/mL, abnormal ECG (atrial fibrillation &/or LV hypertrophy &/or bundle branch block &/or Q wave), left atrial volume index (LAVI)≥40 mL/m 2 , LV ejection fraction (LVEF)≤55%, and LV mass index. At multivariate analyses (stepwise forward selection applied to univariate predictors), clinical variables (CKD and known cardiovascular disease), ECG (HR 2.66 [95% CI 1.08-6.55]), LAVI≥40 mL/m 2 (HR 2.50 [95% CI 1.28-4.89]), and LVEF≤55% (HR 2.70 [95% CI 1.45-5.04]) remained significantly associated with the outcome. Adding sequentially NTproBNP, ECG, and echo (LAVI, LVEF) to clinical data improved event prediction (Figure) Conclusions: High risk diabetic subjects may be correctly risk stratified integrating sequentially clinical data with NTproBNP, ECG, and echocardiogram

scholarly journals ASSOCIATION OF ATRIAL FIBRILLATION AND LEFT ATRIAL VOLUME INDEX WITH MORTALITY IN PATIENTS WITH COVID-19 PNEUMONIA

2020 ◽  
Author(s):  
Antonello D Andrea ◽  
Vincenzo Russo ◽  
Gianluca Manzo ◽  
Valerio Giordano ◽  
Marco Di Maio ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Volume Index ◽  
Atrial Volume ◽  
Left Atrial Volume Index
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