Document Detail


Impact of metabolic syndrome on procedural outcomes in patients with atrial fibrillation undergoing catheter ablation.
MedLine Citation:
PMID:  22464257     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to investigate impact of metabolic syndrome (MS) on outcomes of catheter ablation in patients with atrial fibrillation (AF) in terms of recurrence and quality of life (QoL).
BACKGROUND: MS, a proinflammatory state with hypertension, diabetes, dyslipidemia, and obesity, is presumed to be a close associate of AF.
METHODS: In this prospective study, 1,496 consecutive patients with AF undergoing first ablation (29% with paroxysmal AF, 26% with persistent AF, and 45% with long-standing persistent AF) were classified into those with MS (group 1; n = 485) and those without MS (group 2; n = 1,011). Patients were followed for recurrence and QoL. The Medical Outcomes Study SF-36 Health Survey was used to assess QoL at baseline and 12 month after ablation.
RESULTS: After 21 ± 7 months of follow-up, 189 patients in group 1 (39%) and 319 in group 2 (32%) had arrhythmia recurrence (p = 0.005). When stratified by AF type, patients with nonparoxysmal AF in group 1 failed more frequently compared with those in group 2 (150 [46%] vs. 257 [35%], p = 0.002); no difference existed in the subgroup with paroxysmal AF (39 [25%] vs. 62 [22%], p = 0.295). Group 1 patients had significantly lower baseline scores on all SF-36 Health Survey subscales. At follow-up, both mental component summary (Δ5.7 ± 2.5, p < 0.001) and physical component summary (Δ9.1 ± 3.7, p < 0.001) scores improved in group 1, whereas only mental component summary scores (Δ4.6 ± 2.8, p = 0.036) were improved in group 2. In the subgroup with nonparoxysmal AF, MS, sex, C-reactive protein ≥0.9 mg/dl, and white blood cell count were independent predictors of recurrence.
CONCLUSIONS: Baseline inflammatory markers and the presence of MS predicted higher recurrence after single-catheter ablation only in patients with nonparoxysmal AF. Additionally, significant improvements in QoL were observed in the post-ablation MS population.
Authors:
Sanghamitra Mohanty; Prasant Mohanty; Luigi Di Biase; Rong Bai; Agnes Pump; Pasquale Santangeli; David Burkhardt; Joseph G Gallinghouse; Rodney Horton; Javier E Sanchez; Shane Bailey; Jason Zagrodzky; Andrea Natale
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  59     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-02     Completed Date:  2012-05-17     Revised Date:  2013-02-13    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1295-301     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, TX 78705, USA.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Atrial Fibrillation / diagnosis,  epidemiology*,  surgery*
C-Reactive Protein / metabolism
Catheter Ablation / adverse effects,  methods*
Cohort Studies
Comorbidity
Electrocardiography / methods
Female
Follow-Up Studies
Humans
Leukocyte Count
Linear Models
Male
Metabolic Syndrome X / diagnosis,  epidemiology*
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Proportional Hazards Models
Prospective Studies
Quality of Life*
Recurrence
Reference Values
Risk Assessment
Sex Factors
Tachycardia, Paroxysmal / diagnosis,  epidemiology*,  surgery*
Treatment Outcome
Chemical
Reg. No./Substance:
9007-41-4/C-Reactive Protein
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2012 Apr 3;59(14):1302-3   [PMID:  22464258 ]
J Am Coll Cardiol. 2013 Jan 8;61(1):110-1   [PMID:  23287379 ]
J Am Coll Cardiol. 2013 Jan 8;61(1):109-10   [PMID:  23287378 ]

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