Association of right bundle branch block or intraventricular conduction delay with recurrence of atrial fibrillation after catheter ablation

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Annals of Noninvasive Electrocardiology Pub Date : 2023-09-10 DOI:10.1111/anec.13083

Sung Ho Lee MD, PhD, Ji-Hoon Choi MD, Seung-Jung Park MD, PhD, Kyoung-Min Park MD, PhD, June Soo Kim MD, PhD, Young Keun On MD, PhD

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Abstract

Background

The association between bundle branch block (BBB) and recurrence of atrial fibrillation (AF) after catheter ablation is unclear. The aim of this study was to determine whether AF combined with BBB is associated with AF recurrence after catheter ablation.

Methods

A total of 477 consecutive AF patients who underwent catheter ablation were included. The AF patients were divided into three groups according to BBB: AF without BBB (n = 427), AF with right bundle branch block (AF with RBBB) (n = 16), and AF with intraventricular conduction delay (AF with IVCD) (n = 34).

Results

Of the 477 AF patients (mean age 57 years, 81% men, median CHA₂DS₂-VASc score of 1), 16 (3.4%) patients had RBBB, and 34 (7.1%) patients had IVCD. During a mean follow-up of 15.2 ± 6.7 months, 119 patients (24.9%) had recurrence of AF. Of these, 111 (26%) patients were in the AF without BBB group, with 2 (12.5%) and 6 (17.6%) patients in the RBBB and IVCD groups, respectively. The Kaplan–Meier estimate of the rate of recurrent AF was not significantly different among the three groups (p = .39). Multivariable analysis showed that persistent AF (HR 1.7, 95% CI 1.15–2.50, p = .007), chronic kidney disease (HR 2.94, 95% CI 1.20–7.17, p = .01), and left atrial diameter (HR 1.04, 95% CI 1.009–1.082, p = .01) were significantly associated with AF recurrence.

Conclusion

AF with BBB was not significantly associated with the recurrence of AF after catheter ablation in middle-aged patients with low-risk cardiovascular profile.

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导管消融后房颤复发与右束分支阻滞或室内传导延迟的关系

背景:束支阻滞(BBB)与导管消融后房颤(AF)复发的关系尚不清楚。本研究的目的是确定房颤合并血脑屏障是否与导管消融后房颤复发有关。方法连续477例房颤患者行导管消融治疗。根据血脑屏障情况将房颤患者分为3组:无血脑屏障房颤(n = 427)、右束支阻滞房颤(n = 16)、室内传导延迟房颤(n = 34)。结果477例房颤患者(平均年龄57岁，81%为男性，CHA2DS2-VASc中位评分为1)，16例(3.4%)患者有RBBB, 34例(7.1%)患者有IVCD。在平均15.2±6.7个月的随访中，有119例(24.9%)患者发生房颤复发，其中无血凝血组111例(26%)，RBBB组2例(12.5%)，IVCD组6例(17.6%)。Kaplan-Meier估计的房颤复发率在三组间无显著差异(p = 0.39)。多变量分析显示，持续性房颤(HR 1.7, 95% CI 1.15-2.50, p = 0.007)、慢性肾脏疾病(HR 2.94, 95% CI 1.20-7.17, p = 0.01)和左房内径(HR 1.04, 95% CI 1.009-1.082, p = 0.01)与房颤复发显著相关。结论中年低危心血管患者房颤伴血脑梗死与房颤消融后复发无显著相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Noninvasive Electrocardiology 医学-心血管系统

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation. ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.