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Acute myocardial injury after radiofrequency catheter ablation: impact on pulmonary vein reconnection and relevant factors

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Abstract

Radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) causes myocardial injury and induces high-sensitive cardiac troponin I (hs-TnI) release into the systemic circulation. Several factors are considered to be associated with myocardial injury after ablation, but few studies showed the relationship between the value of myocardial injury marker after the RFCA and relevant factors. AF patients who underwent primary RFCA were enrolled from the Osaka Rosai Atrial Fibrillation ablation (ORAF) registry. The relationship between hs-TnI after the RFCA and PV reconnection (PVR) was evaluated. The impact of relevant factors, including baseline patient characteristics, detail of procedure on myocardial injury was investigated. This study included 407 patients (median age was 71 years, the ratio of female was 30.7%). Late arrhythmia recurrence was observed in 111 patients (27.3%) and 66 patients were underwent repeated ablation. PVR was observed in 33 patients (50.0%). The hs-TnI level was significantly lower in the patients with PVR than those without PVR (1.150 ng/ml vs 1.921 ng/ml, p = 0.040). Paroxysmal AF and age were significantly associated with acute myocardial injury after the RFCA (standardized beta coefficient = 0.206 and p < 0.001, standardized beta coefficient = − 0.114 and p = 0.043, respectively). The hs-TnI after RFCA was significantly higher in PAF patients than PerAF (p < 0.001), even if application number and total application time were taken into consideration. Acute myocardial injury after RFCA was significantly lower in the patients with PVR than those without PVR. Age and AF type were significantly and strongly associated with acute myocardial injury after the RFCA.

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Acknowledgements

The authors thank clinical engineers in Osaka Rosai Hospital for their technical assistance during the electrophysiological study and Mr. John Martin for his linguistic assistance with this manuscript.

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Authors and Affiliations

  1. Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan

    Masamichi Yano, Yasuyuki Egami, Syodai Kawanami, Hiroki Sugae, Kohei Ukita, Akito Kawamura, Hitoshi Nakamura, Yutaka Matsuhiro, Koji Yasumoto, Masaki Tsuda, Naotaka Okamoto, Yasuharu Matsunaga-Lee, Masami Nishino & Jun Tanouchi

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  1. Masamichi Yano
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  2. Yasuyuki Egami
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  3. Syodai Kawanami
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  4. Hiroki Sugae
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  5. Kohei Ukita
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  6. Akito Kawamura
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  7. Hitoshi Nakamura
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  8. Yutaka Matsuhiro
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  9. Koji Yasumoto
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  11. Naotaka Okamoto
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  12. Yasuharu Matsunaga-Lee
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  13. Masami Nishino
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  14. Jun Tanouchi
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Correspondence to Masami Nishino.

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Yano, M., Egami, Y., Kawanami, S. et al. Acute myocardial injury after radiofrequency catheter ablation: impact on pulmonary vein reconnection and relevant factors. Heart Vessels 37, 812–820 (2022). https://doi.org/10.1007/s00380-021-01972-2

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  • DOI: https://doi.org/10.1007/s00380-021-01972-2

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