Key result
Severe FMR linked to lower three-month and long-term PVI efficacy.
Why the study?
Functional mitral regurgitation observed in patients with AF could affect the effectiveness of sinus rhythm restoring procedures, but its impact on PVI efficacy in patients with preserved EF required evaluation.
Does significant functional mitral regurgitation predict lower efficacy of pulmonary vein isolation in patients with atrial fibrillation and preserved ejection fraction?
Observational (n=136)
Does significant functional mitral regurgitation predict lower efficacy of pulmonary vein isolation in patients with atrial fibrillation and preserved ejection fraction?
Significant functional mitral regurgitation assessed by TEE is a negative prognostic factor for the efficacy of pulmonary vein isolation in patients with atrial fibrillation and preserved ejection fraction.
Severe F-MR on baseline TEE signals lower PVI efficacy in AF with preserved EF; leaves open whether MR modification improves ablation outcomes.
Background and Objectives: Functional mitral regurgitation (F-MR) observed in patients with atrial fibrillation could affect the effectiveness of the sinus rhythm restoring procedures. The aim of the study was to evaluate the impact of F-MR on pulmonary vein isolation (PVI) efficacy in patient with preserved ejection fraction (EF). Materials and Methods: One hundred and thirty-six patients with EF ≥ 50% (65.4% males; mean age 56 ± 11 years) with symptomatic paroxysmal or persistent AF qualified for PVI were enrolled into the study. F-MR assessment was performed in transthoracic (TTE) and transesophageal (TEE) echocardiography before the PVI procedure. PVI efficacy was evaluated in three-month and long-term follow-up. Results: F-MR was diagnosed in 74.3% patient in transthoracic echocardiography (TTE) (trace: 26.5%, mild: 43.4%, moderate: 3.7%, severe 0.7%) and 94.9% in transesophageal echocardiography (TEE) (trace: 17.6%, mild: 59.6%, moderate: 16.2%, severe: 1.5%). The PVI three-month efficacy was 75.7% in the three-month and 64% in the long-term observation. Severe F-MR in TEE at baseline was associated with lower three-month PVI efficacy (p = 0.012), while moderate to severe F-MR in TEE was related to inefficient PVI assessed in long-term follow-up (p = 0.041). Conclusions: Significant F-MR confirmed by TEE predicts three-month as well as long-term PVI efficacy.
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Cichoń et al. (2021) conducted an observational in Atrial fibrillation with preserved ejection fraction (n=136). Functional mitral regurgitation (F-MR) vs. No or less severe functional mitral regurgitation was evaluated on Pulmonary vein isolation efficacy at three months and long-term (p=0.012). Severe functional mitral regurgitation assessed by transesophageal echocardiography was associated with lower three-month (p=0.012) and long-term (p=0.041) efficacy of pulmonary vein isolation.
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