Key result
Peak oxygen consumption and ventilatory anaerobic threshold measured 1 month post-ablation were significantly associated with atrial fibrillation recurrence (AUC 0.786 and 0.789, respectively; P<0.01).
Why the study?
Cardiopulmonary function is hypothesized to be associated with AF/AT recurrence after AF ablation, but the relationship after successful ablation remains to be clarified.
Do peak oxygen consumption and ventilatory aerobic threshold measured by CPET predict AF/AT recurrence after ablation in patients with paroxysmal AF?
Observational (n=31)
Do peak oxygen consumption and ventilatory aerobic threshold measured by CPET predict AF/AT recurrence after ablation in patients with paroxysmal AF?
Cardiopulmonary exercise testing parameters (peak VO2 and VAT) measured 1 month after AF ablation are significantly associated with and can help predict AF/AT recurrence.
May support post-ablation risk stratification in paroxysmal AF; leaves open prospective validation before clinical adoption.
Background The cardiopulmonary function is hypothesized to be associated with atrial fibrillation/atrial tachyarrhythmia (AF/AT) recurrence after AF ablation. Purpose To clarify the relationship between the cardiopulmonary function after successful ablation and AF/AT recurrence. Methods We examined 31 patients with paroxysmal AF who underwent AF ablation. Cardiopulmonary exercise testing (CPET) was performed at 1month after the ablation. A continuously increasing loading method on a bicycle ergometer was employed for the CPET. Results No adverse events, including AF/AT recurrence, occurred during the CPET. Among 31 patients, AT/AF recurrence was observed in seven (23%). The ventilatory anaerobic threshold (VAT) and peak oxygen consumption (VO2) were significantly higher in patients without AF/AT recurrence than in those with AT/AF recurrences (peak VO2 23.6 ± 5.7 vs 17.2 ± 4.1 mL/kg/min; VAT, 16.7 ± 2.8 vs 13.8 ± 2.7 mL/min/kg). The areas under the receiver operating characteristic curve for the peak VO2 and VAT were 0.786 ( P < .01) and 0.789( P < .01), respectively. Both indices had a sensitivity of 70%–80% and specificity of 70%–80% for predicting AT/AF recurrence. Similar results were obtained for the percent values of the predicted peak VO2 and VAT. Conclusions The present pilot study found that CPET can be performed safely at approximately 1 month after AF ablation. The peak VO2 and VAT were significantly associated with AT/AF recurrence. The peak VO2 and VAT were thought to provide helpful information regarding AT/AF recurrence.
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Yamashita et al. (2020) conducted an observational in paroxysmal atrial fibrillation (n=31). Cardiopulmonary exercise testing (peak VO2 and VAT) was evaluated on AT/AF recurrence (AUC 0.786 for peak VO2; AUC 0.789 for VAT, p=< .01). Peak oxygen consumption and ventilatory anaerobic threshold measured 1 month post-ablation were significantly associated with atrial fibrillation recurrence (AUC 0.786 and 0.789, respectively; P<0.01).
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