Additional posterior wall isolation is associated with gastric hypomotility in catheter ablation of atrial fibrillation.


Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
01 03 2021
Historique:
received: 17 06 2020
revised: 25 09 2020
accepted: 23 10 2020
pubmed: 2 11 2020
medline: 29 5 2021
entrez: 1 11 2020
Statut: ppublish

Résumé

Gastric hypomotility (GH) is a possible complication of catheter ablation (CA) for atrial fibrillation (AF). However, it is unclear which factors are associated with GH. We sought to elucidate the relationship between the CA procedure and GH. The study population consisted of 254 patients who underwent CA for AF from November 2017 to October 2018. Finally, 119 patients were enrolled and divided into two groups: with or without GH (GH or non-GH groups). To evaluate the association with GH, the clinical backgrounds and procedure characteristics of the radiofrequency CA (RFCA) were compared between the two groups. The median age was 69 years old with 34% of female. GH were observed in 27.7% of patients who underwent RFCA, which was significantly higher than that in the cohort of patients who underwent esophago-gastro-duodenoscopy during the same time period (1.9%: 151 in 8063 patients, p < 0.0001). According to the detailed RFCA procedure, additional posterior wall isolation with pulmonary vein isolation (PVI) had a higher prevalence of GH than that with only PVI (54.8% vs. 18.2%; odds ratio 5.46, 95%CI 2.24-13.32, p = 0.0002). After an adjustment using a multivariate logistic analysis, a posterior wall isolation with the PVI was identified as the only independent predictor for GH (odds ratio 5.01, 95%CI 1.94-13.43, p = 0.0009). Additional posterior wall isolation with PVI was associated with gastric hypomotility.

Sections du résumé

BACKGROUND
Gastric hypomotility (GH) is a possible complication of catheter ablation (CA) for atrial fibrillation (AF). However, it is unclear which factors are associated with GH. We sought to elucidate the relationship between the CA procedure and GH.
METHODS
The study population consisted of 254 patients who underwent CA for AF from November 2017 to October 2018. Finally, 119 patients were enrolled and divided into two groups: with or without GH (GH or non-GH groups). To evaluate the association with GH, the clinical backgrounds and procedure characteristics of the radiofrequency CA (RFCA) were compared between the two groups.
RESULTS
The median age was 69 years old with 34% of female. GH were observed in 27.7% of patients who underwent RFCA, which was significantly higher than that in the cohort of patients who underwent esophago-gastro-duodenoscopy during the same time period (1.9%: 151 in 8063 patients, p < 0.0001). According to the detailed RFCA procedure, additional posterior wall isolation with pulmonary vein isolation (PVI) had a higher prevalence of GH than that with only PVI (54.8% vs. 18.2%; odds ratio 5.46, 95%CI 2.24-13.32, p = 0.0002). After an adjustment using a multivariate logistic analysis, a posterior wall isolation with the PVI was identified as the only independent predictor for GH (odds ratio 5.01, 95%CI 1.94-13.43, p = 0.0009).
CONCLUSIONS
Additional posterior wall isolation with PVI was associated with gastric hypomotility.

Identifiants

pubmed: 33130261
pii: S0167-5273(20)34060-2
doi: 10.1016/j.ijcard.2020.10.069
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

103-108

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Auteurs

Jun Oikawa (J)

Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.

Hidehira Fukaya (H)

Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan. Electronic address: hidehira@med.kitasato-u.ac.jp.

Takuya Wada (T)

Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan.

Ai Horiguchi (A)

Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.

Jun Kishihara (J)

Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.

Akira Satoh (A)

Department of Cardiology, Yokohama Asahi chuo general hospital, Yokohama, Japan.

Daiki Saito (D)

Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.

Tetsuro Sato (T)

Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.

Gen Matsuura (G)

Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.

Yuki Arakawa (Y)

Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.

Shuhei Kobayashi (S)

Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.

Yuki Shirakawa (Y)

Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.

Ryo Nishinarita (R)

Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.

Naruya Ishizue (N)

Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.

Chikatoshi Katada (C)

Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan.

Satoshi Tanabe (S)

Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Sagamihara, Japan.

Shinichi Niwano (S)

Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.

Junya Ako (J)

Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.

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