Preprocedural Troponin T Levels Predict the Improvement in the Left Ventricular Ejection Fraction After Catheter Ablation of Atrial Fibrillation/Flutter

Author:

Aoyama Daisetsu1,Miyazaki Shinsuke1ORCID,Hasegawa Kanae1,Kaseno Kenichi1,Ishikawa Eri1,Mukai Moe1,Nodera Minoru1,Miyahara Kosuke1,Matsui Akira1,Shiomi Yuichiro1,Tama Naoto1,Ikeda Hiroyuki1,Fukuoka Yoshitomo1,Morishita Tetsuji1,Ishida Kentaro1,Uzui Hiroyasu1,Tada Hiroshi1

Affiliation:

1. Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui Japan

Abstract

Background Left ventricular (LV) systolic dysfunction is reversible in some patients once the arrhythmia is controlled. However, identifying this arrhythmia‐induced cardiomyopathy among patients with LV systolic dysfunction is challenging. We explored the factors predicting the reversibility of the LV ejection fraction (LVEF) after catheter ablation of atrial fibrillation and/or atrial flutter in patients with LV systolic dysfunction. Methods and Results Forty patients with a reduced LVEF (LVEF <50%; 66.2±10.7 years; 32 men) who underwent atrial fibrillation/atrial flutter ablation were included. Transthoracic echocardiography was performed before and during the early (<4 days) and late phases (>3 months) after the ablation. Responders were defined as having a normalized LVEF (≥50%) during the late phase after the ablation. The LVEF improved from 39.8±8.8 to 50.9±10.9% at 1.2±0.6 days after the procedure, and to 56.2±12.2% at 9.6±8.0 months after the procedure (both for P <0.001). Thirty (75.0%) patients were responders. The preprocedural echocardiographic parameters were comparable between the responders and nonresponders. In the multivariate analysis, the preprocedural high‐sensitivity troponin T was the only independent predictor of the recovery of the LV dysfunction during the late phase after ablation (odds ratio, 1.17; 95% CI, 1.06–1.33; P =0.001), and a level of ≤12 pg/mL predicted recovery of the LV dysfunction with a high accuracy (sensitivity, 90.0%; specificity, 76.7%; positive predictive value, 56.3%; and negative predictive value, 95.8%). Conclusions Preprocedural high‐sensitivity troponin T levels might be a simple and useful parameter for predicting the reversibility of the LV systolic dysfunction after atrial fibrillation/atrial flutter ablation in patients with a reduced LVEF.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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