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Relationship between pre-procedural non-ischemic ST-segment depression and the clinical outcomes after catheter

Masamichi Yano1, Yasuyuki Egami1, Shodai Kawanami1

  • 1Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan.

Journal of Cardiology
|February 23, 2023
PubMed

Insights

ST-segment depression in atrial fibrillation (AF) patients undergoing catheter ablation (CA) is linked to a higher risk of late AF recurrence (LRAF). This finding highlights the importance of monitoring ST-segment changes in AF patients post-ablation.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Internal Medicine

Background:

  • ST-segment depression during sinus rhythm often indicates coronary artery disease (CAD).
  • The clinical significance of ST-segment depression in atrial fibrillation (AF) patients, particularly concerning outcomes after catheter ablation (CA), remains unclear.

Purpose of the Study:

  • To investigate the association between ST-segment depression before CA and late recurrence of AF (LRAF) in persistent AF (PerAF) patients.
  • To identify factors associated with ST-segment depression and its relationship with LRAF post-CA.

Main Methods:

  • Analysis of 551 persistent AF patients from the ORAF registry without prior CAD history.
  • Patients were categorized based on the presence of ST-segment depression before CA.
  • Kaplan-Meier and multivariate Cox proportional hazards analyses were used to assess the risk of LRAF.

Main Results:

  • 189 out of 551 patients exhibited ST-segment depression.
  • ST-segment depression was independently associated with a significantly higher risk of LRAF (p < 0.001).
  • Patients with ST-segment depression ≥0.15 mV had a higher LRAF risk; lead location and depression type showed no significant differences.

Conclusions:

  • Non-ischemic ST-segment depression during AF rhythm is significantly associated with LRAF post-CA in PerAF patients.
  • ST-segment depression serves as a potential predictor of AF recurrence after ablation.
Abstract

Keywords:
Catheter ablationElectrocardiographyPersistent atrial fibrillationRecurrenceST-segment depression

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