title: Impact of diastolic dysfunction on the outcome of catheter ablation in patients with atrial fibrillation.
abstract: OBJECTIVE
  To evaluate the impact of diastolic dysfunction on the outcome of atrial fibrillation (AF) ablation.
  
  
  METHODS
  Eighty consecutive patients with drug-refractory symptomatic AF who underwent AF ablation were enrolled (65 males, 58 ± 10 years, 65 paroxysmal AF, 15 persistent AF). All patients underwent extensive pulmonary vein isolation with a double lasso technique using CARTO MERGE. Diastolic dysfunction was defined as a ratio of the mitral inflow early filling velocity to the velocity of the early medial mitral annular ascent of >10. The clinical and echocardiographic data were compared between the patients with and without diastolic dysfunction, and between the patients with and without AF recurrences after the AF ablation.
  
  
  RESULTS
  Twenty-nine out of all the patients (36.3%) had diastolic dysfunction. Compared with the patients without diastolic dysfunction, the patients with diastolic dysfunction had higher brain natriuretic peptide (p=0.001) and C-reactive protein (p=0.023) levels, and a larger left atrial diameter (P=0.019). The AF-free rate after a single or repeat AF ablation procedure in the patients with diastolic dysfunction was lower than that in those without diastolic dysfunction (p=0.005 and p=0.013 by the log-rank test, respectively). In the univariate analysis, the patients with persistent AF and diastolic dysfunction were likely to have AF recurrences after a single AF ablation. The multivariate analysis indicated diastolic dysfunction as the only independent predictor of an AF recurrence after a single AF ablation (P=0.023).
  
  
  CONCLUSIONS
  The patients with diastolic dysfunction had a worse outcome of the AF ablation not only for a single procedure but also a repeat procedure.
authors: Department of Cardiology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666 Japan. koichiro@qf6.so-net.ne.jp
authors: Koichiro
authors: K
authors: Ejima
authors: Morio
authors: M
authors: Shoda
authors: Kotaro
authors: K
authors: Arai
authors: Atsushi
authors: A
authors: Suzuki
authors: Daigo
authors: D
authors: Yagishita
authors: Yoshimi
authors: Y
authors: Yagishita
authors: Bun
authors: B
authors: Yashiro
authors: Takahiro
authors: T
authors: Sato
authors: Tetsuyuki
authors: T
authors: Manaka
authors: Kyomi
authors: K
authors: Ashihara
authors: Nobuhisa
authors: N
authors: Hagiwara
mesh_terms: D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000601:surgery*; D017115:Catheter Ablation; D003971:Diastole; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome