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Article: Incidence of nausea/vomiting following propofol sedation with adaptive servo-ventilation for atrial fibrillation ablation.

Sakanoue, Haruna / Yamaji, Hirosuke / Okamoto, Sayaka / Okano, Kumi / Fujita, Yuka / Higashiya, Shunichi / Murakami, Takashi / Kusachi, Shozo

Journal of arrhythmia

2024 Volume 40, Issue 2, Page(s) 289–296

Abstract: Background: Postoperative nausea and vomiting (PONV) following atrial fibrillation (AF) ablation can cause considerable distress.: Aim: Continuous intravenous propofol sedation with adaptive servo-ventilation (ASV) with or without an analgesic, ... ...

Abstract	Background: Postoperative nausea and vomiting (PONV) following atrial fibrillation (AF) ablation can cause considerable distress. Aim: Continuous intravenous propofol sedation with adaptive servo-ventilation (ASV) with or without an analgesic, pentazocine, during AF ablation was studied in 272 consecutive patients with paroxysmal, persistent, and long-standing persistent AF. The study objectives were to determine the incidence of PONV after AF ablation and to assess the predictive value of factors for PONV using the area under the receiver operating characteristic curve (AUC). Results: The present sedation maneuver was successfully accomplished with a low incidence of hypotension and without discontinuation of ablation or switching to general anesthesia, while maintaining an acceptable procedural time (102 ± 32 min). The incidence of PONV was 5.5% (15/272). Nausea occurred in nine patients after an average of 4.6 ± 3.5 h (range: 2-12 h) postablation, and vomiting with nausea occurred in six patients after an average of 4.5 ± 3.1 h (range: 1-9 h) postablation. The postablation interval did not differ significantly between the occurrence of nausea and nausea accompanied by vomiting. AUCs based on various factors, including the Apfel score, ranged from 0.55 to 0.67, indicating low accuracy in predicting PONV occurrence. Conclusions: The incidence of PONV after propofol sedation with ASV was the lowest (5.5%) reported to date. Scoring systems, which included the Apfel score, were ineffective in predicting PONV. The low PONV incidence in addition to the efficacy of propofol sedation with ASV revealed the adequacy of this regimen for AF ablation.
Language	English
Publishing date	2024-02-27
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2696593-8
ISSN	1883-2148 ; 1880-4276
ISSN (online)	1883-2148
ISSN	1880-4276
DOI	10.1002/joa3.13012
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Article ; Online: Small solitary atrial fractionated electrogram zone as a novel ablation target for persistent atrial fibrillation.

Yamaji, Hirosuke / Kawafuji, Souhei / Sano, Masaya / Higashiya, Shunichi / Murakami, Takashi / Kawamura, Hiroshi / Murakami, Masaaki / Kamikawa, Shigeshi / Kusachi, Shozo

Journal of cardiovascular electrophysiology

2023 Volume 34, Issue 5, Page(s) 1130–1140

Abstract: Introduction: Various adjunctive approaches to pulmonary vein isolation (PVI) have been attempted for persistent atrial fibrillation (perAF) and longstanding persistent AF (ls-perAF). We aimed to identify the novel zones responsible for perpetuation of ... ...

Abstract	Introduction: Various adjunctive approaches to pulmonary vein isolation (PVI) have been attempted for persistent atrial fibrillation (perAF) and longstanding persistent AF (ls-perAF). We aimed to identify the novel zones responsible for perpetuation of AF. Methods: To identify novel zones acting as a source of perAF and ls-perAF after PVI/re-PVI, we performed fractionation mapping in 258 consecutive patients with perAF (n = 207) and ls-perAF (n = 51) in whom PVI/re-PVI failed to restore sinus rhythm. Results: In 15 patients with perAF (5.8%: 15/258), fractionation mapping identified a small solitary zone (<1 cm Conclusions: Using fractionation mapping, this study identified a small SAFE zone surrounded characteristically by a homogeneous, relatively organized, low-excitability EGM lesion. The ablation of the small SAFE zone terminated AF in all patients, demonstrating it as a substrate for perpetuated AF. Our findings provide novel ablation targets in perAF patients with prolonged AF duration. Further studies to confirm the present results are warranted.
MeSH term(s)	Humans ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/surgery ; Treatment Outcome ; Catheter Ablation/adverse effects ; Catheter Ablation/methods ; Electrophysiologic Techniques, Cardiac ; Pulmonary Veins/surgery ; Recurrence
Language	English
Publishing date	2023-04-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	1025989-2
ISSN	1540-8167 ; 1045-3873
ISSN (online)	1540-8167
ISSN	1045-3873
DOI	10.1111/jce.15912
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Zs.A 2863: Show issues

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Article ; Online: Optimal prevention method of phrenic nerve injury in superior vena cava isolation: efficacy of high-power, short-duration radiofrequency energy application on the risk points.

Yamaji, Hirosuke / Higashiya, Shunichi / Murakami, Takashi / Kawamura, Hiroshi / Murakami, Masaaki / Kamikawa, Shigeshi / Kusachi, Shozo

Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing

2022 Volume 66, Issue 6, Page(s) 1465–1475

Abstract: Background or purpose: Superior vena cava isolation (SVCI) is widely performed adjunctively to atrial fibrillation (AF) ablation. Right phrenic nerve injury (PNI) is a complication of this procedure. The purpose of the study is to determine the optimal ... ...

Abstract	Background or purpose: Superior vena cava isolation (SVCI) is widely performed adjunctively to atrial fibrillation (AF) ablation. Right phrenic nerve injury (PNI) is a complication of this procedure. The purpose of the study is to determine the optimal PNI prevention method in SVCI. Methods: A total of 1656 patients who underwent SVCI between 2009 and 2022 were retrospectively examined. PNI was diagnosed based on the diaphragm position and movement in the upright position on chest radiographs before and after SVCI. Results: With the introduction of various PN monitoring systems over the years, the incidence of SVCI-associated PNI has decreased. However, complete PNI avoidance has not been achieved. PNI incidence according to fluoroscopy-guided PN monitoring, high-output pace-guided, compound motor action potential-guided, and 3-dimensional electro-anatomical mapping (EAM) systems was 8.1% (38/467), 2.7% (13/476), 2.4% (4/130), and 2.8% (11/389), respectively. However, a high-power, short-duration (50 W/7 s) radiofrequency (RF) energy application only on PNI risk points tagged by a 3-dimensional EAM system completely avoids PNI (0%; 0 /160 since April 2021). PNI showed no symptoms and recovered within an average of 188 days post-SVCI, except for a few patients who required > 1 year. Conclusions: Although PNI incidence decreased annually with the introduction of various monitoring systems, these monitoring systems did not prevent PNI completely. Most notably, the delivery of a high-power, short-duration RF energy only on risk points tagged by EAM prevented PNI completely. PNI recovered in all patients. The application of higher-power, shorter-duration RF energy on risk points tagged by EAM appears to be an optimal PNI prevention maneuver.
MeSH term(s)	Humans ; Vena Cava, Superior/diagnostic imaging ; Vena Cava, Superior/surgery ; Phrenic Nerve/injuries ; Retrospective Studies ; Atrial Fibrillation ; Diaphragm/surgery ; Treatment Outcome ; Peripheral Nerve Injuries/etiology ; Peripheral Nerve Injuries/prevention & control ; Catheter Ablation/adverse effects ; Catheter Ablation/methods ; Pulmonary Veins/surgery
Language	English
Publishing date	2022-12-17
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1329179-8
ISSN	1572-8595 ; 1383-875X
ISSN (online)	1572-8595
ISSN	1383-875X
DOI	10.1007/s10840-022-01449-w
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Zs.A 5214: Show issues

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Article: Reproducibility of cardiopulmonary exercise testing between one after and 1-3 weeks after elective percutaneous coronary intervention.

Tanaka, Ryou / Waki, Isao / Kamikawa, Shigeshi / Yamashita, Daiki / Tabita, Natsumi / Nishimura, Saori / Higashiya, Shunich / Yamaji, Hirosuke / Murakami, Takashi / Kusachi, Shozo

Journal of exercise rehabilitation

2023 Volume 19, Issue 5, Page(s) 268–274

Abstract: Prompt prescription and early initiation of exercise training are essential for patients undergoing elective percutaneous coronary intervention (PCI). We hypothesized that cardiopulmonary exercise testing (CPET) parameters determined the day after ... ...

Abstract	Prompt prescription and early initiation of exercise training are essential for patients undergoing elective percutaneous coronary intervention (PCI). We hypothesized that cardiopulmonary exercise testing (CPET) parameters determined the day after elective PCI during hospitalization would not differ from those obtained 1-3 weeks post-PCI in patients with stable coronary heart disease (CHD). CPET was performed the day after and 1-3 weeks (13±4.6; 7-21 days) after PCI. CPET was performed with a bicycle ergometer up to the ventilatory aerobic threshold (VAT) on the day after PCI. Symptom-limited CPET was conducted 1-3 weeks after PCI. No complications arose from the tests. There were no significant differences in %VAT (next day: 88.6±16.7 vs. 1-3 weeks later: 91.4%±18.7%), the workload at the VAT (51.8±11.0 W vs. 52.9± 11.6 W), heart rate (HR) at the VAT (95.3±105 beats/min vs. 94.1±11.3 beats/min), or metabolic equivalent (METs) at the VAT (3.69±0.69 vs. 3.84±0.78) between the two sessions. The slope of linear regression for two repeated measurements was close to 1 (%VAT, 1.02; workload at the VAT, 0.95; METs at the VAT, 1.03), except for HR (0.70). Bland-Altman plots revealed the reproducibility of all four CPET measurements between the two sessions. In conclusion, CPET up to the VAT can be performed safely 1-day post-PCI in patients with stable CHD. CPET parameters do not significantly differ between testing performed the day after and 1-3 weeks after PCI. Next-day CPET during hospitalization after PCI may enable prompt exercise prescription without the need for another CPET 1-3 weeks later.
Language	English
Publishing date	2023-10-25
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2756291-8
ISSN	2288-1778 ; 2288-176X
ISSN (online)	2288-1778
ISSN	2288-176X
DOI	10.12965/jer.2346376.188
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Article ; Online: Radiofrequency Catheter Ablation for Atrial Fibrillation Patients on Hemodialysis (From the Kansai Plus Atrial Fibrillation Registry)　- Clinical Impact of Early Recurrence.

Onishi, Naoaki / Kaitani, Kazuaki / Nakagawa, Yoshihisa / Kobori, Atsushi / Inoue, Koichi / Kurotobi, Toshiya / Morishima, Itsuro / Matsui, Yumie / Yamaji, Hirosuke / Nakazawa, Yuko / Kusano, Kengo / Shimizu, Yukiko / Hanazawa, Koji / Tamura, Toshihiro / Izumi, Chisato / Morimoto, Takeshi / Ono, Koh / Kimura, Takeshi / Shizuta, Satoshi

Circulation journal : official journal of the Japanese Circulation Society

2024

Abstract: Background: Catheter ablation (CA) for atrial fibrillation (AF) in patients on hemodialysis (HD) is reported to have a high risk of late recurrence (LR). However, the relationship between early recurrence (ER) within a 90-day blanking period after CA in ...

Abstract	Background: Catheter ablation (CA) for atrial fibrillation (AF) in patients on hemodialysis (HD) is reported to have a high risk of late recurrence (LR). However, the relationship between early recurrence (ER) within a 90-day blanking period after CA in AF patients and LR in HD patients remains unclear.Methods and Results: Of the 5,010 patients in the Kansai Plus Atrial Fibrillation Registry, 5,009 were included in the present study. Of these patients, 4,942 were not on HD (non-HD group) and 67 were on HD (HD group). HD was an independent risk factor for LR after the initial CA (adjusted hazard ratio 1.6; 95% confidence interval 1.1-2.2; P=0.01). In patients with ER, the rate of sinus rhythm maintenance at 3 years after the initial CA was significantly lower in the HD than non-HD group (11.4% vs. 35.4%, respectively; log-rank P=0.004). However, in patients without ER, there was no significant difference in the rate of sinus rhythm maintenance at 3 years between the HD and non-HD groups (67.7% vs. 74.5%, respectively; log-rank P=0.62). Conclusions: ER in HD patients was a strong risk factor for LR. However, even HD patients could expect a good outcome without ER after the initial CA.
Language	English
Publishing date	2024-01-11
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2068090-9
ISSN	1347-4820 ; 1346-9843
ISSN (online)	1347-4820
ISSN	1346-9843
DOI	10.1253/circj.CJ-23-0671
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Article ; Online: Rates of atrial flutter occurrence and cavotricuspid isthmus reconduction after prophylactic isthmus ablation performed during atrial fibrillation ablation: a clinical study, review, and comparison with previous findings.

Yamaji, Hirosuke / Higashiya, Shunichi / Murakami, Takashi / Kawamura, Hiroshi / Murakami, Masaaki / Kamikawa, Shigeshi / Kusachi, Shozo

Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing

2021 Volume 64, Issue 1, Page(s) 67–76

Abstract: Purpose: Based on the high rate of coexisting atrial fibrillation (AF) and atrial flutter (AFL), prophylactic cavotricuspid isthmus ablation (CTIA) adjunctive to AF ablation has recently been attempted in patients with AF and without AFL. The present ... ...

Abstract	Purpose: Based on the high rate of coexisting atrial fibrillation (AF) and atrial flutter (AFL), prophylactic cavotricuspid isthmus ablation (CTIA) adjunctive to AF ablation has recently been attempted in patients with AF and without AFL. The present study aimed to determine the rates of AFL occurrence and CTI reconduction after performing CTI ablation adjunctive to AF ablation. Methods: We analyzed the data of 3833 consecutive patients with AF, who underwent prophylactic CTIA with AF ablation between 2009 and 2020. Results: In all patients, CTIA and AF ablations were successful. Clinical AFL occurred in seven patients (0.18%, 7/3,833), and the observed rate was lower than those reported for cases of AF ablation without CTIA and for those of CTIA for pure AFL. A second ablation was needed in 745 patients at a median of 253 days (25 and 75 percentiles, 116 and 775 days) after the first ablation. In 12.1% (90/745) of the patients, CTI reconduction was observed. The reconduction rate was lower than that previously reported for CTIA for pure AFL. Conclusions: The present retrospective study found acceptably low rates of clinical AFL occurrence and CTI reconduction following prophylactic CTIA performed with AF ablation, which was supported by the findings obtained after performing a comparison of the rates with those of other ablations (AF ablation only and CTIA for pure AFL). Considering the high correlation between AF and AFL, the present study provided information regarding the efficacy of adjunctive CTIA.
MeSH term(s)	Atrial Fibrillation ; Atrial Flutter/epidemiology ; Catheter Ablation ; Humans ; Recurrence ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-11-09
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1329179-8
ISSN	1572-8595 ; 1383-875X
ISSN (online)	1572-8595
ISSN	1383-875X
DOI	10.1007/s10840-021-01087-8
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Zs.A 5214: Show issues

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Article ; Online: Usefulness of three-dimensional pulmonary vein-left atrium image reconstructed from non-enhanced computed tomography for atrial fibrillation ablation.

Kawafuji, Souhei / Yamaji, Hirosuke / Kayama, Masaaki / Akiyama, Akitaka / Miyahara, Motoaki / Tomiya, Takumi / Koumoto, Takuto / Akagi, Takuya / Higashiya, Shunichi / Murakami, Takashi / Kusachi, Shozo

The international journal of cardiovascular imaging

2023 Volume 39, Issue 12, Page(s) 2517–2526

Abstract: Enhanced computed tomography (CT) is unsuitable for patients with reduced renal function and/or allergy for contrast medium (CM). CT image registration into an electroanatomic system (EAMS) is essential to perform pulmonary vein isolation (PVI) safely ... ...

Abstract	Enhanced computed tomography (CT) is unsuitable for patients with reduced renal function and/or allergy for contrast medium (CM). CT image registration into an electroanatomic system (EAMS) is essential to perform pulmonary vein isolation (PVI) safely and smoothly in patients with atrial fibrillation (AF). To create three-dimensional pulmonary vein-left atrium (3D PV-LA) images from non-enhanced CT images to register them into EAMS for AF ablation. Using a non-enhanced ECG-gated image, 3D PV-LA images were generated by our developed techniques with an EnSite image analyzing tool for patients unfit for CM use (n = 100). Segmentation between tissues was performed as follows: tissues distal from or close to PV-LA were segmented in transverse slices to clearly show the whole LA. Tissues bordering PV-LA, including the pulmonary artery, left ventricle, and right atrium, were segmented manually with great care. Practical ablation parameters were compared with those obtained from enhanced CT (n = 100). 3D PV-LA image reconstruction from non-enhanced CT imaging required a longer time than that from enhanced CT (42 ± 6 vs 14 ± 3 min). All 100 PV-LA non-enhanced CT images were successfully reconstructed and registered into the EAM system without the need for re-segmentation. Practical ablation parameters, including procedural time and AF recurrence rate, did not differ between imaging methods. This study provides clinically useful information on a detailed methodology for 3D PV-LA image reconstruction using non-enhanced CT. Non-enhanced CT 3D PV-LA images were successfully registered into the EAM system and useful for patients unsuitable for CM use.
MeSH term(s)	Humans ; Atrial Fibrillation/diagnostic imaging ; Atrial Fibrillation/surgery ; Pulmonary Veins/diagnostic imaging ; Pulmonary Veins/surgery ; Treatment Outcome ; Predictive Value of Tests ; Heart Atria/diagnostic imaging ; Heart Atria/surgery ; Tomography, X-Ray Computed/methods ; Contrast Media ; Imaging, Three-Dimensional/methods ; Catheter Ablation/methods
Chemical Substances	Contrast Media
Language	English
Publishing date	2023-08-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	2055311-0
ISSN	1875-8312 ; 1573-0743 ; 1569-5794 ; 0167-9899
ISSN (online)	1875-8312 ; 1573-0743
ISSN	1569-5794 ; 0167-9899
DOI	10.1007/s10554-023-02943-6
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Zs.A 2104: Show issues

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Article ; Online: Efficacy of an Adjunctive Electrophysiological Test-Guided Left Atrial Posterior Wall Isolation in Persistent Atrial Fibrillation Without a Left Atrial Low-Voltage Area.

Yamaji, Hirosuke / Higashiya, Shunichi / Murakami, Takashi / Hina, Kazuyoshi / Kawamura, Hiroshi / Murakami, Masaaki / Kamikawa, Shigeshi / Hirohata, Satoshi / Kusachi, Shozo

Circulation. Arrhythmia and electrophysiology

2020 Volume 13, Issue 8, Page(s) e008191

Abstract: Background: Electrical remodeling precedes structural remodeling. In adjunctive left atrial (LA) low-voltage area (LVA) ablation to pulmonary vein isolation of atrial fibrillation (AF), LA areas without LVA have not been targeted for ablation. We ... ...

Abstract	Background: Electrical remodeling precedes structural remodeling. In adjunctive left atrial (LA) low-voltage area (LVA) ablation to pulmonary vein isolation of atrial fibrillation (AF), LA areas without LVA have not been targeted for ablation. We studied the effect of adjunctive LA posterior wall isolation (PWI) on persistent AF without LA-LVA according to electrophysiological testing (EP test). Methods: We examined consecutive patients with persistent AF with (n=33) and without (n=111) LA-LVA. Patients without LA-LVA were randomly assigned to EP test-guided (n=57) and control (n=54) groups. In the EP test-guided group, an adjunctive PWI was performed in those with positive results (PWI subgroup; n=24), but not in those with negative results (n=33). The criteria for positive EP tests were an effective refractory period ≤180 ms, effective refractory period>20 ms shorter than the other sites, and/or induction of AF/atrial tachycardia (AT) during measurements. LVA ablation was performed in the patients with LA-LVA. Results: During the follow-up period (62±33 weeks), the EP test-guided group had significantly lower recurrence rates (19%,11/57 versus 41%, 22/54, Conclusions: This pilot study proposed that an EP test-guided adjunctive PWI of persistent AF without LA-LVA potentially reduced AF/AT recurrences. The results suggest that there is an AF substrate in the LA with altered electrophysiological function even when there is no LA-LVA. Graphic Abstract: A graphic abstract is available for this article.
MeSH term(s)	Action Potentials ; Aged ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/physiopathology ; Atrial Fibrillation/surgery ; Atrial Function, Left ; Atrial Remodeling ; Catheter Ablation ; Electrophysiologic Techniques, Cardiac ; Female ; Heart Atria/physiopathology ; Heart Atria/surgery ; Heart Rate ; Humans ; Japan ; Male ; Middle Aged ; Pilot Projects ; Predictive Value of Tests ; Pulmonary Veins/physiopathology ; Pulmonary Veins/surgery ; Recurrence ; Time Factors ; Treatment Outcome
Language	English
Publishing date	2020-07-13
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2426129-4
ISSN	1941-3084 ; 1941-3149
ISSN (online)	1941-3084
ISSN	1941-3149
DOI	10.1161/CIRCEP.119.008191
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Zs.A 6667: Show issues

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Article ; Online: Catheter Ablation for Paroxysmal Atrial Fibrillation With Sick Sinus Syndrome: Insights From the Kansai Plus Atrial Fibrillation Registry.

Heart, lung & circulation

2022 Volume 32, Issue 2, Page(s) 205–214

Abstract: Background: Coexisting sick sinus syndrome (SSS) is associated with both electrical and structural atrial remodelling in patients with atrial fibrillation (AF). Limited data are available concerning catheter ablation (CA) for AF in this condition. This ... ...

Abstract	Background: Coexisting sick sinus syndrome (SSS) is associated with both electrical and structural atrial remodelling in patients with atrial fibrillation (AF). Limited data are available concerning catheter ablation (CA) for AF in this condition. This study investigated the efficacy of CA as a curative therapy for AF and SSS in a large-scale prospective multicentre registry. Methods: The Kansai Plus Atrial Fibrillation (KPAF) registry enrolled 5,010 consecutive patients who underwent CA for AF; this included 3,133 patients with paroxysmal AF (mean age, 66 years; male, 69.3%; mean CHA Results: The AF-free survival did not significantly differ between patients with and those without SSS (n=2,818) after the initial (log-rank p=0.864) and final sessions (log-rank p=0.268). Pacemakers were implanted in 48 patients with SSS, and implantation in this group was significantly associated with AF recurrence, including early recurrence (adjusted odds ratio, 3.57; 95% confidence interval, 1.67-7.64; p=0.002). The remaining 85.3% of patients with SSS did not require pacemaker implantation at 3 years after CA. Conclusions: Coexisting SSS did not adversely affect recurrence-free survival after CA for paroxysmal AF. Pacemaker implantation was not required in most patients with SSS, with AF recurrence serving as a strong predictor for this.
MeSH term(s)	Humans ; Male ; Aged ; Atrial Fibrillation/complications ; Atrial Fibrillation/surgery ; Sick Sinus Syndrome ; Prospective Studies ; Catheter Ablation ; Registries ; Treatment Outcome
Language	English
Publishing date	2022-10-20
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2020980-0
ISSN	1444-2892 ; 1443-9506
ISSN (online)	1444-2892
ISSN	1443-9506
DOI	10.1016/j.hlc.2022.09.007
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Zs.A 4988: Show issues

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Article ; Online: Atrial Fibrillation Ablation Outcomes and Heart Failure (from the Kansai Plus Atrial Fibrillation Registry).

The American journal of cardiology

2022 Volume 189, Page(s) 108–118

Abstract: The impact of rhythm outcomes on heart failure (HF) hospitalizations remains unknown after radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). We sought to elucidate whether AF recurrence was associated with HF hospitalizations after AF ... ...

Abstract	The impact of rhythm outcomes on heart failure (HF) hospitalizations remains unknown after radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). We sought to elucidate whether AF recurrence was associated with HF hospitalizations after AF RFCA. We conducted a large-scale, prospective, multicenter, observational study (Kansai Plus Atrial Fibrillation Registry), enrolling 5,010 consecutive patients (age 64 ± 10 years, 27.3% female, and 35.7% nonparoxysmal AF) who underwent an initial AF RFCA at 26 centers. The median follow-up duration was 2.9 years. The cumulative 3-year incidence of HF hospitalizations after the initial RFCA was 1.84% (0.69%/year). Hospitalized patients with HF were older with a higher prevalence of nonparoxysmal AF, renal dysfunction, diabetes, and underlying heart disease pre-RFCA. HF hospitalizations occurred more often in patients with than without recurrences (3.27 vs 0.84%, log-rank p <0.0001). After adjusting for confounders using a Cox model, AF recurrence remained an independent predictor of HF hospitalizations (hazard ratio [HR] 2.84, 95% confidence interval [CI] 1.80 to 4.47, p <0.0001). AF recurrence was a distinct HF hospitalization risk in patients with a left ventricular ejection fraction ≥50% (HR 4.54, 95% CI 2.38 to 8.65, p <0.0001) but not <50% (HR 1.31, 95% CI 0.65 to 2.62, p = 0.45), with significant interactions. Furthermore, patients with AF recurrences within 1 year had a greater HF hospitalization risk after 1 year (1.61% vs 0.79%, log-rank p = 0.019). In conclusion, AF recurrence after RFCA was independently associated with HF hospitalizations.
MeSH term(s)	Humans ; Female ; Middle Aged ; Aged ; Male ; Atrial Fibrillation/complications ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/surgery ; Stroke Volume ; Prospective Studies ; Ventricular Function, Left ; Treatment Outcome ; Heart Failure ; Catheter Ablation ; Registries ; Recurrence
Language	English
Publishing date	2022-12-14
Publishing country	United States
Document type	Observational Study ; Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2022.11.038
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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

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