Key result
Myocardial inflammation linked to ~55-point lower primary RFA success vs intact myocardium.
Why the study?
The study aimed to evaluate myocardial inflammatory changes using endomyocardial biopsy in patients undergoing radiofrequency ablation for idiopathic atrial fibrillation.
Does the presence of myocardial inflammation or fibrosis reduce the effectiveness of radiofrequency ablation in patients with idiopathic atrial fibrillation?
Observational (n=67)
No
Does the presence of myocardial inflammation or fibrosis reduce the effectiveness of radiofrequency ablation in patients with idiopathic atrial fibrillation?
Absolute Event Rate: 34.4% vs 88.9%
Subclinical myocardial inflammation and fibrosis are frequently present in 'idiopathic' atrial fibrillation and significantly reduce the success rate of radiofrequency ablation.
Myocardial inflammation and fibrosis were associated with lower primary RFA success in idiopathic AF; hypothesis-generating and requires prospective validation before clinical adoption.
The aim of the study was to evaluate the inflammatory changes in the myocardium, based on endomyocardial biopsy (EMB) data in patients undergoing radiofrequency ablation (RFA) for idiopathic atrial fibrillation (AF). A total of 67 patients with idiopathic AF were enrolled in the study. Patients underwent the intracardiac examination, RFA of AF, and EMB with histological and immunohistochemical studies. The catheter-treatment effectiveness, and occurrence of early and late recurrences of atrial tachyarrhythmias, were assessed depending on the identified histological changes. Nine patients (13.4%) did not have any histological changes in the myocardium according to EMB. Fibrotic changes were detected in 26 cases (38.8%). Inflammatory changes according to the Dallas criteria were observed in 32 patients (47.8%). The follow-up period for patients averaged 19.3 ± 3.7 months. The effectiveness rates of primary RFA were 88.9% in patients with the intact myocardium, 46.2% in patients with fibrotic changes of varying severity, and 34.4% in patients with the presence of criteria for myocarditis. No early recurrence of arrhythmias was observed in patients with unchanged myocardia. The presence of inflammatory and fibrotic changes in the myocardium increased the rates of early and late arrhythmia recurrences and accordingly halved the effectiveness RFA of AF.
No takes yet. Share an insight, caveat, or question.
Баталов et al. (2023) conducted an observational in Idiopathic atrial fibrillation (n=67). Myocardial inflammation or fibrosis vs. Intact myocardium was evaluated on Effectiveness of primary RFA (freedom from arrhythmia recurrence). Myocardial inflammation and fibrosis reduced the success rate of primary radiofrequency ablation to 34.4% and 46.2%, respectively, compared to 88.9% in patients with intact myocardium.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: