Arrhythmias & electrophysiology
Impact of Mitral Regurgitation on Outcomes of Catheter Ablation for Atrial Fibrillation (AF) With Left Ventricular Systolic Dysfunction
Authors' conclusion
In patients with AF and LVSD, the degree of FMR did not impact the success of ablation. There was a significant reduction in FMR and FTR at 12 months following CA. Patients with AF and LVSD should be strongly considered for AF ablation irrespective of the degree of mitral regurgitation.
Study context
- Population
- Individuals with AF and LVSD with at least mild FMR undergoing CA; patients with primary mitral valve disease excludedpatients who underwent CA
- Participants
- 235 individuals
- Comparison
- FMR severity at baseline and CA outcomes
- Mildn = 117
- Moderate/severen = 118
- Outcome
- Baseline LVEF
- Follow-up
- Baseline
Main finding
As reported in the abstract
P < 0.001
Further findings
Tricuspid regurgitation · baseline
P < 0.001
Recurrent atrial arrhythmia · 12 months following CA
P = 0.940
Severity of FMR and arrhythmia recurrence / left ventricular (LV) recovery
| OR (95% CI) | P value | ||
|---|---|---|---|
| Severity of FMRArrhythmia recurrence | 1.15 (0.54–1.86) | P = 0.601 | |
| Severity of FMRLV recovery | 1.07 (0.67–1.25) | P = 0.153 | |
| 0.512Odds ratio (log scale) |
Change in LV and LA dimensions and MR responders · 12 months
| OR (95% CI) | P value | ||
|---|---|---|---|
| Change in LV dimensionsAssociated with MR responders | 0.93 (0.87–0.99) | P = 0.022 | |
| Change in LA sizeNot associated with MR responders | 0.98 (0.97–1.03) | P = 0.984 | |
| 0.512Odds ratio (log scale) |
| Outcome | P value |
|---|---|
| Change in LV and LA dimensions and MR responders · 12 monthsMR improvement vs non-improvement · greater reduction in LV size with MR improvement | P = 0.004 |
- Recurrent atrial arrhythmia — Overall recurrent atrial arrhythmia
- 101 of 235 (43.0%)
- Change in LV and LA dimensions and MR responders: MR improvement change in LV size −5.0 (IQR −9.3–-1.0)
- Change in LV and LA dimensions and MR responders: non-improvement change in LV size −1.0 (IQR −5.0–2.5)
LA size · baseline
- LA size did not differ significantly across FMR groups
- P = 0.233
≥1 grade reduction in significant FMR and FTR · 12 months
- Significant FMR with ≥1 grade reduction
- 89%
- Significant FTR with ≥1 grade reduction
- 85%
Original publication
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