Thyroid hormone (TH) is known to enhance arrhythmogenicity, and high-normal thyroid function is related with an increased recurrence of atrial fibrillation (AF) after catheter ablation. However, the impact of thyroid hormone replacement (THR) on AF ablation is not well known. This study evaluated 1163 consecutive paroxysmal AF patients [160 (14%) on THR and 1003 (86%) without THR] undergoing their first catheter ablation. A total of 146 patients on THR and 146 controls were generated by propensity matching, based on calculated risk factor scores, using a logistic model (age, sex, body mass index, and left atrium size). The presence of non-pulmonary vein (PV) triggers was disclosed by a high-dose isoproterenol challenge (up to 30 mu g/min) after PV isolation. Clinical characteristics were not different between the groups. When compared to the control, non-PV triggers were significantly greater in the THR patients [112 (77%) vs. 47 (32%), P < 0.001], and most frequently originated from the right atrium (95 vs. 56%, P < 0.001). Other sources of non-PV triggers were the interatrial septum (25 vs. 11%, P = 0.002), coronary sinus (70 vs. 52%, P = 0.01), left atrial appendage (47 vs. 34%, P = 0.03), crista terminalis/superior vena cava (11 vs. 8%, P = 0.43), and mitral valve annulus (7 vs. 5%, P = 0.45) (THR vs. control), respectively. After mean follow-up of 14.7 +/- 5.2 months, success rate was lower in patients on THR therapy [94 (64.4%)] compared to patients not receiving THR therapy [110 (75.3%), log-rank test value = 0.04]. Right atrial non-PV triggers were more prevalent in AF patients treated with THR. Elimination of non-PV triggers provided better arrhythmia-free survival in the non-THR group.
通讯机构:[2]St Davids Med Ctr, Texas Cardiac Arrhythmia Inst, 3000 N I-35,Suite 720, Austin, TX 78705 USA;[3]Dell Med Sch, Austin, TX 78712 USA;[6]Univ Texas Austin, Dept Biomed Engn, Austin, TX 78712 USA;[9]Calif Pacific Med Ctr, San Francisco, CA 94114 USA
推荐引用方式(GB/T 7714):
Kim Ki-Hun,Mohanty Sanghamitra,Mohanty Prasant,et al.Prevalence of right atrial non-pulmonary vein triggers in atrial fibrillation patients treated with thyroid hormone replacement therapy[J].JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY.2017,49(2):111-117.doi:10.1007/s10840-017-0234-x.
APA:
Kim, Ki-Hun,Mohanty, Sanghamitra,Mohanty, Prasant,Trivedi, Chintan,Morris, Eli Hamilton...&Natale, Andrea.(2017).Prevalence of right atrial non-pulmonary vein triggers in atrial fibrillation patients treated with thyroid hormone replacement therapy.JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY,49,(2)
MLA:
Kim, Ki-Hun,et al."Prevalence of right atrial non-pulmonary vein triggers in atrial fibrillation patients treated with thyroid hormone replacement therapy".JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY 49..2(2017):111-117