Related Experiment Video
Updated: Oct 23, 2025
Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
Published on: May 26, 2015
Improvement of Vascular Endothelial Function Reflects Nonrecurrence After Catheter Ablation for Atrial Fibrillation
Hisanori Kanazawa1,2, Koichi Kaikita1, Miwa Ito1
1Department of Cardiovascular Medicine Graduate School of Medical Sciences Kumamoto University Kumamoto Japan.
Insights
Atrial fibrillation (AF) is linked to impaired vascular endothelial function. Restoring sinus rhythm after catheter ablation may improve this function and reduce AF recurrence.
Area of Science:
- Cardiology
- Vascular Biology
- Medical Devices
Background:
- Vascular endothelial dysfunction is a concern in atrial fibrillation (AF), but its clinical significance is not fully understood.
- Reactive hyperemia-peripheral arterial tonometry (RHI) assesses endothelial function.
- The impact of restoring sinus rhythm on endothelial function post-atrial fibrillation catheter ablation requires investigation.
Purpose of the Study:
- To investigate the relationship between vascular endothelial function, measured by RHI, and outcomes after catheter ablation (CA) for AF.
- To determine if improvements in endothelial function correlate with reduced AF recurrence following CA.
Main Methods:
- A retrospective study of 214 patients undergoing CA for AF.
- Vascular endothelial function was assessed using the natural logarithmic transformed reactive hyperemia-peripheral arterial tonometry index (LnRHI) before and at 3 and 6 months after CA.
- Statistical analyses included multivariate logistic and Cox hazard regression, and receiver operating characteristic (ROC) analysis.
Main Results:
- Patients with AF had significantly lower LnRHI compared to those in sinus rhythm.
- AF was an independent risk factor for reduced LnRHI.
- LnRHI improved significantly 3 and 6 months post-CA in patients without AF recurrence.
- Changes in LnRHI from pre-ablation to 3 months post-ablation independently predicted AF recurrence (HR, 0.106; P=0.001).
- Decreased LnRHI post-ablation was a significant marker for AF recurrence (AUC, 0.792).
Conclusions:
- Atrial fibrillation is independently associated with impaired vascular endothelial function.
- Successful long-term sinus rhythm restoration after CA may improve endothelial function.
- Improved endothelial function following CA might be linked to a lower risk of AF recurrence.
Abstract:
Background The clinical implication of vascular endothelial dysfunction in patients with atrial fibrillation (AF) remains unclear. This study aimed to elucidate the correlation between changes in vascular endothelial function assessed by reactive hyperemia-peripheral arterial tonometry and the effect of sinus rhythm restoration after catheter ablation (CA) for AF. Methods and Results Consecutive 214 patients who underwent CA for AF were included in this single center, retrospective study. The natural logarithmic transformed reactive hyperemia-peripheral arterial tonometry index (LnRHI) of all patients was measured before CA as well as 3 and 6 months after CA. LnRHI in sinus rhythm was significantly higher than that in AF before CA. Multivariate logistic regression analysis revealed that the presence of AF was an independent risk factor for lowering of LnRHI (odds ratio, 4.092; P=0.002) before CA. The LnRHI was significantly improved 3 and 6 months after CA in patients without AF recurrence. Multivariate Cox hazard analysis revealed that changes in LnRHI from before to 3 months after CA independently correlated with recurrence of AF (hazard ratio, 0.106; P=0.001). Receiver operating characteristic analysis showed the decrease in LnRHI levels from before to 3 months after CA as a significant marker that suspects AF recurrence (area under the curve, 0.792; log-rank test, P<0.001). Conclusions The presence of AF was independently correlated with the impaired vascular endothelial function assessed by the reactive hyperemia-peripheral arterial tonometry. Long-term sinus rhythm restoration after CA for AF might contribute to the improvement of vascular endothelial function, which may reflect the nonrecurrence of AF.
