Impact of metabolic syndrome on procedural outcomes in patients with atrial fibrillation undergoing catheter ablation

Sanghamitra Mohanty, Prasant Mohanty, Luigi Di Biase, Rong Bai, Agnes Pump, Pasquale Santangeli, David Burkhardt, Joseph G. Gallinghouse, Rodney Horton, Javier E. Sanchez, Shane Bailey, Jason Zagrodzky, Andrea Natale

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)1295-1301
Number of pages7
JournalJournal of the American College of Cardiology
Volume59
Issue number14
DOIs
StatePublished - Apr 3 2012
Externally publishedYes

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Catheter Ablation
Atrial Fibrillation
Recurrence
Quality of Life
Health Surveys
Dyslipidemias
Leukocyte Count
C-Reactive Protein
Cardiac Arrhythmias
Obesity
Outcome Assessment (Health Care)
Prospective Studies
Hypertension

Keywords

  • atrial fibrillation
  • CRP
  • metabolic syndrome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Impact of metabolic syndrome on procedural outcomes in patients with atrial fibrillation undergoing catheter ablation. / Mohanty, Sanghamitra; Mohanty, Prasant; Di Biase, Luigi; Bai, Rong; Pump, Agnes; Santangeli, Pasquale; Burkhardt, David; Gallinghouse, Joseph G.; Horton, Rodney; Sanchez, Javier E.; Bailey, Shane; Zagrodzky, Jason; Natale, Andrea.

In: Journal of the American College of Cardiology, Vol. 59, No. 14, 03.04.2012, p. 1295-1301.

Research output: Contribution to journalArticle

Mohanty, S, Mohanty, P, Di Biase, L, Bai, R, Pump, A, Santangeli, P, Burkhardt, D, Gallinghouse, JG, Horton, R, Sanchez, JE, Bailey, S, Zagrodzky, J & Natale, A 2012, 'Impact of metabolic syndrome on procedural outcomes in patients with atrial fibrillation undergoing catheter ablation', Journal of the American College of Cardiology, vol. 59, no. 14, pp. 1295-1301. https://doi.org/10.1016/j.jacc.2011.11.051
Mohanty, Sanghamitra ; Mohanty, Prasant ; Di Biase, Luigi ; Bai, Rong ; Pump, Agnes ; Santangeli, Pasquale ; Burkhardt, David ; Gallinghouse, Joseph G. ; Horton, Rodney ; Sanchez, Javier E. ; Bailey, Shane ; Zagrodzky, Jason ; Natale, Andrea. / Impact of metabolic syndrome on procedural outcomes in patients with atrial fibrillation undergoing catheter ablation. In: Journal of the American College of Cardiology. 2012 ; Vol. 59, No. 14. pp. 1295-1301.
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abstract = "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.",
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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

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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.

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