Digital Assessment of Endothelial Function in Atrial Fibrillation and Short-Term Results of Pulmonary Vein Isolation

Abstract

Background: Digital pulse amplitude augmentation in reactive hyperemia is a novel measure of peripheral endothelial function and a candidate predictor for atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI).Methods: Twenty-two patients (mean age, 58±8 years; 19 male) with paroxysmal AF (n=17) or persistent AF (n=5) were enrolled. Before PVI, digital pulse amplitude was recorded by fingertip tonometry during reactive hyperemia under sinus rhythm (n=14) or AF (n=8), and the reactive hyperemia index (RHI) was calculated. AF recurrence was determined by ECG-based episodes following a 3-month blanking period.Results: AF recurred in 7 patients (32%) during a mean follow-up period of 165±66 days. RHI was 1.61±0.40 in patients with AF recurrence and 1.72±0.28 in patients without recurrence (p=0.47). Proportional hazards analysis revealed that persistent AF and RHI were significantly associated with AF recurrence (hazard ratio 25.9 [95%CI 2.1–325], p=0.02; hazard ratio 0.04 [95%CI 0.002–0.87], p=0.04, respectively).Conclusion: Digital assessment showed that endothelial function was associated with, but was not the solo predictor for AF recurrence after PVI.