Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO03 - Poster Session III (ID 48) Poster

D-PO03-181 - The Appearance Of Mitral L-wave After Radiofrequency Catheter Ablation In Persistent Atrial Fibrillation: Relationships With Atrial Fibrillation Recurrence (ID 1143)

 M. Shinohara: Nothing relevant to disclose.


Background: The mitral L-wave, mid-diastolic transmitral flow velocity curve in echocardiography, is closely related to the advanced left ventricular diastolic dysfunction. Previous studies reported that the appearance of the mitral L-wave in patients with persistent atrial fibrillation (PeAF) was approximately 30%. The long-term clinical outcomes after radiofrequency catheter ablation (RFCA) in PeAF patients with the mitral L-wave have not yet been studied.
Objective: The aim of this study is to evaluate the association between the time course of the appearance of the mitral L-wave and AF reccurence after RFCA in PeAF patients.
Methods: Among 252 consecutive non-valvular PeAF patients undergoing RFCA, 78 patients with the mitral L-wave (65.1±11.3 years, 49 male) were enrolled. The mitral L-wave was defined as a distinct forward flow velocity curve occurred during diastasis with a peak velocity ≥20 cm/s. Enrolled patients were retrospectively followed for AF recurrence until 12 months after a single RFCA procedure. Echocardiography at 3 months after RFCA were recorded. Enrolled patients were divided into groups with the mitral L-wave (group L) or without the mitral L-wave (group NL) based on the findings of echocardiography. A Multivariate analysis was constructed to assess the factors of late recurrence of AF (LRAF) which means AF recurrence after 3 months.
Results: During follow-up periods, LRAF occured in 35.6% of the enrolled patients. Echocardiography at 3 months after RFCA showed that the mitral L-wave disappeared in 53 of the 78 patients (group NL) and remained in 25 (group L). The ratio of LRAF was significantly higher in the group NL than that in the group L (16/25 [64.0%] versus. 12/53 [22.6%], Odds ratio [OR]: 5.88, 95% confidence interval [CI]: 1.28-30.9, p=0.016). In multivariable regression analysis containing age, sex and other independent variables, the mitral L-wave positivity at 3 months after RFCA was identified as an independent predictor of LRAF (OR: 2.92, 95% CI: 1.60-5.32, p=0.037).
Conclusion: RFCA contributes to the disappearance of the mitral L-wave in PeAF patients. However, remaining the mitral L-wave even after RFCA could predict late recurrence of AF.