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Relationship between coronary blood flow and improvement of cardiac function after catheter ablation for persistent

Masao Takahashi1, Tomoyuki Arai2, Takashi Kimura2

  • 1Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan. seikouudokuforever0419@yahoo.co.jp.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
|April 12, 2023
PubMed

Insights

Improved coronary blood flow during persistent atrial fibrillation (PeAF) is linked to better heart function after catheter ablation (CA). This study highlights coronary blood flow as a key factor for cardiac recovery in PeAF patients with heart failure.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Heart Failure Management

Background:

  • The impact of coronary blood flow on cardiac function recovery post-catheter ablation (CA) for persistent atrial fibrillation (PeAF) remains underexplored.
  • Persistent AF often coexists with heart failure with reduced ejection fraction (HFrEF), necessitating investigations into factors influencing recovery.

Purpose of the Study:

  • To investigate the association between coronary blood flow during PeAF and the improvement in cardiac function following CA.
  • To identify predictors of left ventricular ejection fraction (LVEF) improvement after successful rhythm control in PeAF patients with HFrEF.

Main Methods:

  • A retrospective case-control study included 85 patients with PeAF and HFrEF undergoing coronary angiography before CA.
  • The primary outcome was LVEF improvement (>50%) at 6 months post-CA, with patients maintaining sinus rhythm.
  • Coronary blood flow was assessed using Thrombolysis in Myocardial Infarction (TIMI) frame count.

Main Results:

  • The LVEF improvement group (N=57) was younger with higher diastolic blood pressure and lower BNP levels than the no-improvement group (N=28).
  • Significantly higher TIMI frame counts were observed in the LVEF improvement group (P<0.001).
  • Mean TIMI frame count emerged as an independent predictor of LVEF improvement (OR, 1.72; P=0.006).

Conclusions:

  • Coronary blood flow is a significant determinant of left ventricular systolic function recovery in patients with PeAF and HFrEF after successful CA.
  • Enhanced coronary microvascular function, indicated by higher TIMI frame counts, is associated with better cardiac outcomes post-ablation.
Abstract

Keywords:
Atrial fibrillationCatheter ablationCoronary blood flowLeft ventricular systolic function

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