Ward Robert C, Larson Kathryn, Hodge David, Slusser Joshua, Medina-Inojosa Jose, Allison Thomas G, Bonikowske Amanda R, DeSimone Christopher V
Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.
J Interv Card Electrophysiol. 2025 Jan 31. doi: 10.1007/s10840-025-01993-1.
Studies have shown a correlation between greater cardiorespiratory fitness (CRF) and lower risk of incident and recurrent atrial fibrillation (AF). Transthoracic echocardiographic (TTE) parameters correlate to CRF and risk of AF. However, there is scarce data regarding the interplay of CRF, echocardiographic parameters, and AF ablation outcomes. Our study sought to investigate how CRF and echocardiographic parameters impact AF ablation outcomes.
We evaluated the Mayo Clinic Cardiorespiratory Exercise database from January 1, 2013, through December 31, 2017, to include all patients who underwent cardiopulmonary exercise testing and an AF ablation in temporal proximity.
A total of 205 patients (mean age 61.2 years, 74% male) were included for analysis. Fitness was calculated with peak VO2 when available and exercise time when VO2 was not available. Lower baseline fitness correlated to larger left atrial volumes, lower medial mitral e' values, and higher E/e' ratios. Lower baseline fitness correlated to higher risk of AF recurrence post-ablation in a simple model, but lost significance when multiple variables were accounted for. Lower baseline fitness also correlated to a higher AF burden post-ablation at one year.
Lower baseline CRF likely correlates to more malignant and difficult to treat AF. Lower fitness also correlated to larger left atria and TTE parameters suggestive of diastolic dysfunction.
研究表明，更高的心肺适能（CRF）与心房颤动（AF）发生和复发风险降低之间存在关联。经胸超声心动图（TTE）参数与CRF及AF风险相关。然而，关于CRF、超声心动图参数与AF消融结果之间相互作用的数据却很少。我们的研究旨在探讨CRF和超声心动图参数如何影响AF消融结果。
我们评估了梅奥诊所2013年1月1日至2017年12月31日的心肺运动数据库，纳入所有在相近时间内接受心肺运动测试和AF消融的患者。
共纳入205例患者（平均年龄61.2岁，74%为男性）进行分析。体能在有峰值VO2时用其计算，无VO2时用运动时间计算。较低的基线体能与较大的左心房容积、较低的二尖瓣E'值及较高的E/E'比值相关。在一个简单模型中，较低的基线体能与消融后AF复发的较高风险相关，但在考虑多个变量时失去显著性。较低的基线体能还与消融后一年时较高的AF负荷相关。
较低的基线CRF可能与更恶性且难以治疗的AF相关。较低的体能还与较大的左心房及提示舒张功能障碍的TTE参数相关。
