Enlarged right atrium predicts pacemaker implantation after atrial fibrillation ablation in patients with tachycardia-bradycardia syndrome
Introduction: Although catheter ablation (CA) of tachycardia-bradycardia syndrome (TBS) in patients with atrial fibrillation (AF) is considered to be an effective treatment strategy, pacemaker implantations (PMIs) are often required even after a successful CA. This study aimed to elucidate the clini...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-12-01
|
| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906723001288 |
| _version_ | 1827591118569603072 |
|---|---|
| author | Toshiki Arai Yu-ki Iwasaki Hiroshi Hayashi Nobuaki Ito Masato Hachisuka Serina Kobayashi Yuhi Fujimoto Kanako Hagiwara Hiroshige Murata Kenji Yodogawa Wataru Shimizu Kuniya Asai |
| author_facet | Toshiki Arai Yu-ki Iwasaki Hiroshi Hayashi Nobuaki Ito Masato Hachisuka Serina Kobayashi Yuhi Fujimoto Kanako Hagiwara Hiroshige Murata Kenji Yodogawa Wataru Shimizu Kuniya Asai |
| author_sort | Toshiki Arai |
| collection | DOAJ |
| description | Introduction: Although catheter ablation (CA) of tachycardia-bradycardia syndrome (TBS) in patients with atrial fibrillation (AF) is considered to be an effective treatment strategy, pacemaker implantations (PMIs) are often required even after a successful CA. This study aimed to elucidate the clinical predictors of a PMI after CA. Methods: From 2011 to 2020, 103 consecutive patients diagnosed with TBS were retrospectively enrolled in the study. Among the 103 patients, 54 underwent a PMI and 49 CA of AF. During 47.4 ± 35.4 months after 1.4 ± 0.6 CA sessions, 37 (75.5%) of 49 patients were free from atrial arrhythmia recurrences. PMIs were performed in 11 patients (PMI group) and the remaining 38 did not receive a PMI (non-PMI group). Results: When comparing the PMI and non-PMI groups, there were no differences in the basic mean heart rate (P = 0.36), maximum pauses detected by 24-hour Holter-monitoring (P = 0.61), and other clinical parameters between the two groups while the right atrial area index was larger (42.1 ± 24.0 vs. 21.8 ± 8.4 cm2/m2 P = 0.002) in the PMI group than non-PMI group. The ROC curve analysis showed that the optimal cutoff point of the ratio of the right atrial area index to the left atrial area index for predicting a PMI following CA was 0.812 (Sensitivity 72.7%, specificity 71.1%, positive predictive value 42.1%, negative predictive value 90.0%, diagnostic accuracy 71.4%, AUC = 0.81). Conclusion: Right atrial enlargement prior to CA was considered to be one of the risk factors for a PMI after CA of AF. |
| first_indexed | 2024-03-09T01:27:16Z |
| format | Article |
| id | doaj.art-5b2ebb15b97040c796fc7c160a95d6bb |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-03-09T01:27:16Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-5b2ebb15b97040c796fc7c160a95d6bb2023-12-10T06:16:31ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672023-12-0149101297Enlarged right atrium predicts pacemaker implantation after atrial fibrillation ablation in patients with tachycardia-bradycardia syndromeToshiki Arai0Yu-ki Iwasaki1Hiroshi Hayashi2Nobuaki Ito3Masato Hachisuka4Serina Kobayashi5Yuhi Fujimoto6Kanako Hagiwara7Hiroshige Murata8Kenji Yodogawa9Wataru Shimizu10Kuniya Asai11Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, JapanCorresponding author at: Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.; Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, JapanDepartment of Cardiovascular Medicine, Nippon Medical School, Tokyo, JapanDepartment of Cardiovascular Medicine, Nippon Medical School, Tokyo, JapanDepartment of Cardiovascular Medicine, Nippon Medical School, Tokyo, JapanDepartment of Cardiovascular Medicine, Nippon Medical School, Tokyo, JapanDepartment of Cardiovascular Medicine, Nippon Medical School, Tokyo, JapanDepartment of Cardiovascular Medicine, Nippon Medical School, Tokyo, JapanDepartment of Cardiovascular Medicine, Nippon Medical School, Tokyo, JapanDepartment of Cardiovascular Medicine, Nippon Medical School, Tokyo, JapanDepartment of Cardiovascular Medicine, Nippon Medical School, Tokyo, JapanDepartment of Cardiovascular Medicine, Nippon Medical School, Tokyo, JapanIntroduction: Although catheter ablation (CA) of tachycardia-bradycardia syndrome (TBS) in patients with atrial fibrillation (AF) is considered to be an effective treatment strategy, pacemaker implantations (PMIs) are often required even after a successful CA. This study aimed to elucidate the clinical predictors of a PMI after CA. Methods: From 2011 to 2020, 103 consecutive patients diagnosed with TBS were retrospectively enrolled in the study. Among the 103 patients, 54 underwent a PMI and 49 CA of AF. During 47.4 ± 35.4 months after 1.4 ± 0.6 CA sessions, 37 (75.5%) of 49 patients were free from atrial arrhythmia recurrences. PMIs were performed in 11 patients (PMI group) and the remaining 38 did not receive a PMI (non-PMI group). Results: When comparing the PMI and non-PMI groups, there were no differences in the basic mean heart rate (P = 0.36), maximum pauses detected by 24-hour Holter-monitoring (P = 0.61), and other clinical parameters between the two groups while the right atrial area index was larger (42.1 ± 24.0 vs. 21.8 ± 8.4 cm2/m2 P = 0.002) in the PMI group than non-PMI group. The ROC curve analysis showed that the optimal cutoff point of the ratio of the right atrial area index to the left atrial area index for predicting a PMI following CA was 0.812 (Sensitivity 72.7%, specificity 71.1%, positive predictive value 42.1%, negative predictive value 90.0%, diagnostic accuracy 71.4%, AUC = 0.81). Conclusion: Right atrial enlargement prior to CA was considered to be one of the risk factors for a PMI after CA of AF.http://www.sciencedirect.com/science/article/pii/S2352906723001288Tachycardia bradycardia syndromeCatheter ablationPacemaker implantationRight atrium volume index |
| spellingShingle | Toshiki Arai Yu-ki Iwasaki Hiroshi Hayashi Nobuaki Ito Masato Hachisuka Serina Kobayashi Yuhi Fujimoto Kanako Hagiwara Hiroshige Murata Kenji Yodogawa Wataru Shimizu Kuniya Asai Enlarged right atrium predicts pacemaker implantation after atrial fibrillation ablation in patients with tachycardia-bradycardia syndrome International Journal of Cardiology: Heart & Vasculature Tachycardia bradycardia syndrome Catheter ablation Pacemaker implantation Right atrium volume index |
| title | Enlarged right atrium predicts pacemaker implantation after atrial fibrillation ablation in patients with tachycardia-bradycardia syndrome |
| title_full | Enlarged right atrium predicts pacemaker implantation after atrial fibrillation ablation in patients with tachycardia-bradycardia syndrome |
| title_fullStr | Enlarged right atrium predicts pacemaker implantation after atrial fibrillation ablation in patients with tachycardia-bradycardia syndrome |
| title_full_unstemmed | Enlarged right atrium predicts pacemaker implantation after atrial fibrillation ablation in patients with tachycardia-bradycardia syndrome |
| title_short | Enlarged right atrium predicts pacemaker implantation after atrial fibrillation ablation in patients with tachycardia-bradycardia syndrome |
| title_sort | enlarged right atrium predicts pacemaker implantation after atrial fibrillation ablation in patients with tachycardia bradycardia syndrome |
| topic | Tachycardia bradycardia syndrome Catheter ablation Pacemaker implantation Right atrium volume index |
| url | http://www.sciencedirect.com/science/article/pii/S2352906723001288 |
| work_keys_str_mv | AT toshikiarai enlargedrightatriumpredictspacemakerimplantationafteratrialfibrillationablationinpatientswithtachycardiabradycardiasyndrome AT yukiiwasaki enlargedrightatriumpredictspacemakerimplantationafteratrialfibrillationablationinpatientswithtachycardiabradycardiasyndrome AT hiroshihayashi enlargedrightatriumpredictspacemakerimplantationafteratrialfibrillationablationinpatientswithtachycardiabradycardiasyndrome AT nobuakiito enlargedrightatriumpredictspacemakerimplantationafteratrialfibrillationablationinpatientswithtachycardiabradycardiasyndrome AT masatohachisuka enlargedrightatriumpredictspacemakerimplantationafteratrialfibrillationablationinpatientswithtachycardiabradycardiasyndrome AT serinakobayashi enlargedrightatriumpredictspacemakerimplantationafteratrialfibrillationablationinpatientswithtachycardiabradycardiasyndrome AT yuhifujimoto enlargedrightatriumpredictspacemakerimplantationafteratrialfibrillationablationinpatientswithtachycardiabradycardiasyndrome AT kanakohagiwara enlargedrightatriumpredictspacemakerimplantationafteratrialfibrillationablationinpatientswithtachycardiabradycardiasyndrome AT hiroshigemurata enlargedrightatriumpredictspacemakerimplantationafteratrialfibrillationablationinpatientswithtachycardiabradycardiasyndrome AT kenjiyodogawa enlargedrightatriumpredictspacemakerimplantationafteratrialfibrillationablationinpatientswithtachycardiabradycardiasyndrome AT watarushimizu enlargedrightatriumpredictspacemakerimplantationafteratrialfibrillationablationinpatientswithtachycardiabradycardiasyndrome AT kuniyaasai enlargedrightatriumpredictspacemakerimplantationafteratrialfibrillationablationinpatientswithtachycardiabradycardiasyndrome |