Relationship between coronary blood flow and improvement of cardiac function after catheter ablation for persistent atrial fibrillation.

Abstract

The relationship between coronary blood flow during atrial fibrillation (AF) and improvement of cardiac function after catheter ablation (CA) for persistent AF (PeAF) is not prominent; this study was conducted to evaluate this relationship. This was a retrospective case-control study. Eighty-five patients with PeAF (resting heart rate < 100bpm) and heart failure with reduced ejection fraction (left ventricular ejection fraction (LVEF) < 40%) who had undergone coronary angiography within 1week before CA were included. All patients could maintain a sinus rhythm for > 6months after CA. The primary outcome was improvement of cardiac function with an LVEF cutoff value of > 50% during sinus rhythm 6months after CA. In the LVEF improvement group (N = 57), patients were younger, with a higher baseline diastolic blood pressure and lower baseline brain natriuretic peptide level than the no LVEF improvement group (N = 28). Heart rate at baseline and 6months after CA and AF duration did not differ between the two groups. Thrombolysis in myocardial infarction frame count parameters was significantly higher in the LVEF improvement (P < 0.001) than in the no LVEF improvement group. Multivariate logistic regression analysis revealed mean thrombolysis in myocardial infarction frame count as an independent factor for LVEF improvement (odds ratio, 1.72 (95% confidence interval 1.17-2.54); P = 0.006). Coronary blood flow in patients with PeAF is strongly associated with improved left ventricular systolic function after the restoration of sinus rhythm by CA for PeAF and heart failure with reduced ejection fraction.