Can We Predict the Outcome of Catheter Ablation for Atrial Fibrillation?

Abstract

Figure. Potential interplay of the feedback loops of atrial remodeling on atrial fibrillation (AF). (Reproduced with permission 4 ).

Quantitative Proteomics of Changes in Energy Metabolism-Related Proteins in Atrial Tissue From Valvular Disease Patients With Permanent Atrial Fibrillation

“…4 LA remodeling includes structural, functional, electrical, metabolic, and neurohumoral changes that occur in response to several pathologic processes. 18, 19 Moreover, a recent microarray study using a pig model of AF showed that the gene changes are more pronounced in the LA than the RA, with considerable overlap in the gene response. 20 Another previous study compared differences in 517 proteins that were expressed differently in the LAA between the SR and AF patients were associated with high-level functions and utilities of the biological system were identified.…”

Heart Failure in Atrial Fibrillation ― An Update on Clinical and Echocardiographic Implications ―

“…18,28,37,38 Although the underlying mechanism is rather complicated, left atrial (LA) structural, electrical, and neurohormonal remodeling is reported to be associated with AF development. 39,40 Recent studies consider LA demonstrated that subsequent HF in AF is associated with a 3.4-fold higher risk of death compared with no evidence of HF. 12 Furthermore, cardiovascular death, including HF, was reported as the leading cause of death among AF patients in some recent studies.…”

“…It is suggested that LA dysfunction or LA fibrosis antedate LA enlargement, 64,65 and the prognostic utility of LA function has also been investigated. 35,40,66 In a substudy of the ENGAGE AF-TIMI 48 study, 35 LA dysfunction assessed by LA emptying fraction [100*(LA maximal volume−LA minimal volume)/LA maximal volume] and LA expansion index [(LA maximal volume−LA minimal volume)/LA minimal volume] were significantly associated with an increased risk for cardiovascular death, HF hospitalization, or both, with an intraobserver intraclass correlation coefficient of 0.95 (range: 0.91-0.99) and an interobserver intraclass correlation coefficient of 0.84 (range: 0.75-0.93). In that study, LA functional impairment was demonstrated as more predictive of these outcomes than LA size.…”

“Hamstring Leaflet” Now Demonstrated to Be a Determinant of Functional Mitral Regurgitation in Patients With Atrial Fibrillation

“…However, it has been controversial whether isolated MV annular dilatation could cause significant MR. 5,6 In this issue of the Journal, the study by MachinoOhtsuka and colleagues 7 provides novel information of the trial fibrillation (AF) is the most common sustained cardiac arrhythmia that clinicians encounter in daily practice. 1 In addition to the evidence of a growing worldwide AF burden, 2 considering the aging of the Japanese population, the prevalence and incidence of AF are expected to increase, making AF a serious epidemic because it is a highly age-related condition. 3 In addition to systemic embolization, heart failure is one of the most dismal consequences associated with AF.…”