Kornej Jelena, Hindricks Gerhard, Arya Arash, Sommer Philipp, Husser Daniela, Rolf Sascha, Bollmann Andreas
Leipzig University Heart Center, Department of Electrophysiology, Germany.
Leipzig University Heart Center, Department of Electrophysiology, Germany.
Int J Cardiol. 2015 Feb 15;181:188-92. doi: 10.1016/j.ijcard.2014.12.039. Epub 2014 Dec 13.
Occlusion of the right coronary artery (RCA) may promote atrial fibrillation (AF) by creating a right atrial substrate. However, the presence and extent of coronary artery disease (CAD) is usually not considered to tailor AF ablation strategies. This study was aimed to analyze the possible association between the presence and extent of CAD and rhythm outcomes of left-atrial AF catheter ablation.
1310 patients (60 ± 10 years, 67% males, 63% paroxysmal AF) from The Leipzig Heart Center AF Ablation Registry undergoing de novo AF catheter ablation were included. CAD was defined as stenosis ≥ 50% in the left main coronary artery and ≥ 70% in one or several of the major coronary arteries. AF recurrences were defined as any atrial arrhythmia lasting >30s and occurring within the first week (early recurrences, ERAF) or between 3 and 12 months (late recurrences, LRAF) after ablation and were assessed with serial 7-day Holter ECG.
152 patients (11.6%) had significant CAD; 89 (59%) had one, 35 (23%) two and 28 (18%) three vessel disease; 72 (47%) patients had RCA involvement. Occurrence of AF recurrences was comparable in CAD (p=0.625 and 0.568 for ERAF and LRAF, respectively). Among patients with CAD, neither the location (RCA versus non-RCA) nor the extent of CAD (single versus multiple vessel disease) was associated with rhythm outcomes after AF catheter ablation (all p>0.05).
The presence and extent of CAD seem not to impact on rhythm outcome of AF catheter ablation in the entire cohort.
右冠状动脉（RCA）闭塞可能通过形成右心房基质促进心房颤动（AF）。然而，冠状动脉疾病（CAD）的存在和程度通常在制定AF消融策略时未被考虑。本研究旨在分析CAD的存在和程度与左心房AF导管消融的节律结局之间的可能关联。
纳入来自莱比锡心脏中心AF消融登记处的1310例接受首次AF导管消融的患者（60±10岁，67%为男性，63%为阵发性AF）。CAD定义为左主干冠状动脉狭窄≥50%，一条或多条主要冠状动脉狭窄≥70%。AF复发定义为消融后第一周内出现的任何持续>30秒的房性心律失常（早期复发，ERAF）或3至12个月内出现的（晚期复发，LRAF），并通过连续7天的动态心电图进行评估。
152例患者（11.6%）患有显著CAD；89例（59%）为单支血管病变，35例（23%）为双支血管病变，28例（18%）为三支血管病变；72例（47%）患者累及RCA。CAD患者中AF复发的发生率相当（ERAF和LRAF的p值分别为0.625和0.568）。在CAD患者中，CAD的部位（RCA与非RCA）和程度（单支血管病变与多支血管病变）均与AF导管消融后的节律结局无关（所有p>0.05）。
在整个队列中，CAD的存在和程度似乎不影响AF导管消融的节律结局。
