TY - JOUR
T1 - Impact of metabolic syndrome on procedural outcomes in patients with atrial fibrillation undergoing catheter ablation
AU - Mohanty, Sanghamitra
AU - Mohanty, Prasant
AU - Di Biase, Luigi
AU - Bai, Rong
AU - Pump, Agnes
AU - Santangeli, Pasquale
AU - Burkhardt, David
AU - Gallinghouse, Joseph G.
AU - Horton, Rodney
AU - Sanchez, Javier E.
AU - Bailey, Shane
AU - Zagrodzky, Jason
AU - Natale, Andrea
N1 - Funding Information:
Dr. Di Biase is a consultant for Hansen Medical and Biosense Webster. Dr. Burkhardt is a consultant for Biosense Webster, St. Jude, and Stereotaxis. Dr. Natale received speaker's honoraria from Boston Scientific, Biosense Webster, St. Jude Medical, Medtronic, and Life Watch; and a research grant from St. Jude Medical . All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
PY - 2012/4/3
Y1 - 2012/4/3
N2 - Objectives: The aim of this study was to investigate impact of metabolic syndrome (MS) on outcomes of catheter ablation in patients with atrial fibrillation (AF) in terms of recurrence and quality of life (QoL). Background: MS, a proinflammatory state with hypertension, diabetes, dyslipidemia, and obesity, is presumed to be a close associate of AF. Methods: In this prospective study, 1,496 consecutive patients with AF undergoing first ablation (29% with paroxysmal AF, 26% with persistent AF, and 45% with long-standing persistent AF) were classified into those with MS (group 1; n = 485) and those without MS (group 2; n = 1,011). Patients were followed for recurrence and QoL. The Medical Outcomes Study SF-36 Health Survey was used to assess QoL at baseline and 12 month after ablation. Results: After 21 ± 7 months of follow-up, 189 patients in group 1 (39%) and 319 in group 2 (32%) had arrhythmia recurrence (p = 0.005). When stratified by AF type, patients with nonparoxysmal AF in group 1 failed more frequently compared with those in group 2 (150 [46%] vs. 257 [35%], p = 0.002); no difference existed in the subgroup with paroxysmal AF (39 [25%] vs. 62 [22%], p = 0.295). Group 1 patients had significantly lower baseline scores on all SF-36 Health Survey subscales. At follow-up, both mental component summary (Δ5.7 ± 2.5, p < 0.001) and physical component summary (Δ9.1 ± 3.7, p < 0.001) scores improved in group 1, whereas only mental component summary scores (Δ4.6 ± 2.8, p = 0.036) were improved in group 2. In the subgroup with nonparoxysmal AF, MS, sex, C-reactive protein ≥0.9 mg/dl, and white blood cell count were independent predictors of recurrence. Conclusions: Baseline inflammatory markers and the presence of MS predicted higher recurrence after single-catheter ablation only in patients with nonparoxysmal AF. Additionally, significant improvements in QoL were observed in the post-ablation MS population.
AB - Objectives: The aim of this study was to investigate impact of metabolic syndrome (MS) on outcomes of catheter ablation in patients with atrial fibrillation (AF) in terms of recurrence and quality of life (QoL). Background: MS, a proinflammatory state with hypertension, diabetes, dyslipidemia, and obesity, is presumed to be a close associate of AF. Methods: In this prospective study, 1,496 consecutive patients with AF undergoing first ablation (29% with paroxysmal AF, 26% with persistent AF, and 45% with long-standing persistent AF) were classified into those with MS (group 1; n = 485) and those without MS (group 2; n = 1,011). Patients were followed for recurrence and QoL. The Medical Outcomes Study SF-36 Health Survey was used to assess QoL at baseline and 12 month after ablation. Results: After 21 ± 7 months of follow-up, 189 patients in group 1 (39%) and 319 in group 2 (32%) had arrhythmia recurrence (p = 0.005). When stratified by AF type, patients with nonparoxysmal AF in group 1 failed more frequently compared with those in group 2 (150 [46%] vs. 257 [35%], p = 0.002); no difference existed in the subgroup with paroxysmal AF (39 [25%] vs. 62 [22%], p = 0.295). Group 1 patients had significantly lower baseline scores on all SF-36 Health Survey subscales. At follow-up, both mental component summary (Δ5.7 ± 2.5, p < 0.001) and physical component summary (Δ9.1 ± 3.7, p < 0.001) scores improved in group 1, whereas only mental component summary scores (Δ4.6 ± 2.8, p = 0.036) were improved in group 2. In the subgroup with nonparoxysmal AF, MS, sex, C-reactive protein ≥0.9 mg/dl, and white blood cell count were independent predictors of recurrence. Conclusions: Baseline inflammatory markers and the presence of MS predicted higher recurrence after single-catheter ablation only in patients with nonparoxysmal AF. Additionally, significant improvements in QoL were observed in the post-ablation MS population.
KW - CRP
KW - atrial fibrillation
KW - metabolic syndrome
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U2 - 10.1016/j.jacc.2011.11.051
DO - 10.1016/j.jacc.2011.11.051
M3 - Article
C2 - 22464257
AN - SCOPUS:84859149210
SN - 0735-1097
VL - 59
SP - 1295
EP - 1301
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 14
ER -