title: Impact of left ventricular diastolic dysfunction on outcome of catheter ablation for atrial fibrillation in patients with hypertrophic cardiomyopathy.
abstract: BACKGROUND
  The relationship between outcome of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) and the severity of left ventricular (LV) diastolic dysfunction in patients with hypertrophic cardiomyopathy (HCM) remains unknown.
  
  
  RESULTS
  Twenty-two HCM patients (12 female, aged 65 ± 11 years) with paroxysmal (n=5; 23%) or persistent (n=17; 77%) AF were enrolled. LV diastolic function was evaluated according to the ratio of the mitral inflow early filling velocity to the velocity of the early medial mitral annular ascent (E/e') measured on pulsed wave and tissue Doppler assessments in all patients. Pulmonary vein isolation was performed in all patients. A second procedure was performed in 3 patients. During a follow-up of 21 ± 12 months, sinus rhythm was maintained in 13 of 22 patients (59%). E/e' was significantly higher in the patients with AF recurrence than in those without (18 ± 7 vs. 11 ± 3; P<0.01). On Kaplan-Meier analysis the prevalence of AF recurrence was significantly higher in patients with E/e' ≥ 15 (n=6) than in those with E/e' <15 (n=16; P<0.01). On multivariate Cox regression analysis the only significant and independent predictor for AF recurrence was E/e' (hazard ratio, 1.16; 95% confidence interval: 1.01-1.37, P=0.03).
  
  
  CONCLUSIONS
  LV diastolic dysfunction evaluated using E/e' was associated with difficulty of rhythm control after RFCA in patients with HCM and AF.
authors.affiliation: Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Hideharu
authors.initials: H
authors.lastname: Okamatsu
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ohara
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kanzaki
authors.forename: Ikutaro
authors.initials: I
authors.lastname: Nakajima
authors.forename: Koji
authors.initials: K
authors.lastname: Miyamoto
authors.forename: Hideo
authors.initials: H
authors.lastname: Okamura
authors.forename: Takashi
authors.initials: T
authors.lastname: Noda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Aiba
authors.forename: Kengo
authors.initials: K
authors.lastname: Kusano
authors.forename: Shiro
authors.initials: S
authors.lastname: Kamakura
authors.forename: Wataru
authors.initials: W
authors.lastname: Shimizu
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Satomi
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D006332:Cardiomegaly / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018487:Ventricular Dysfunction, Left / Q000401:mortality / Q000503:physiopathology / Q000601:surgery