Kataoka Naoya, Imamura Teruhiko, Kinugawa Koichiro
Second Department of Medicine, University of Toyama, Toyama, Japan.
J Cardiol Cases. 2025 Jun 21;32(3):130-133. doi: 10.1016/j.jccase.2025.06.005. eCollection 2025 Sep.
Respiratory stability time (RST) has been proposed as an index for assessing heart failure-related sleep-disordered breathing. This case report examines the impact of catheter ablation for atrial fibrillation (AF) on RST and its relationship with heart failure. Two patients were analyzed: one with preserved ejection fraction (Case 1) and one with reduced ejection fraction (Case 2). In Case 1, RST improved significantly following ablation, accompanied by a decrease in plasma B-type natriuretic peptide levels. In contrast, while B-type natriuretic peptide levels decreased post-ablation in Case 2, RST showed minimal change, suggesting that the hemodynamic effects of restoring sinus rhythm had a lesser impact on respiratory stability. These findings indicate that the contribution of AF to the worsening of sleep-disordered breathing in heart failure differs between preserved and reduced ejection fraction. Further investigation of the association between RST and AF may offer valuable insights into the complex relationship between AF and heart failure.
This case report is the first to demonstrate changes in nocturnal respiratory dysfunction after catheter ablation for atrial fibrillation in heart failure. Quantitative assessment of respiratory stability may help elucidate the role of atrial fibrillation in heart failure.
呼吸稳定时间（RST）已被提议作为评估心力衰竭相关睡眠呼吸障碍的一个指标。本病例报告研究了导管消融治疗心房颤动（AF）对RST的影响及其与心力衰竭的关系。分析了两名患者：一名射血分数保留（病例1），一名射血分数降低（病例2）。在病例1中，消融后RST显著改善，同时血浆B型利钠肽水平降低。相比之下，病例2中虽然消融后B型利钠肽水平降低，但RST变化极小，这表明恢复窦性心律的血流动力学效应对呼吸稳定性的影响较小。这些发现表明，AF对心力衰竭中睡眠呼吸障碍恶化的影响在射血分数保留和降低的情况下有所不同。进一步研究RST与AF之间的关联可能会为AF与心力衰竭之间的复杂关系提供有价值的见解。
本病例报告首次展示了心力衰竭患者导管消融治疗心房颤动后夜间呼吸功能障碍的变化。呼吸稳定性的定量评估可能有助于阐明心房颤动在心力衰竭中的作用。
