Introduction: Dyslipidemia is a modifiable cardiovascular risk factor. However, it is unclear if baseline lipid levels prior to atrial fibrillation (AF) ablation are associated with AF recurrence. Hypothesis: This study aimed to examine if there was an association between baseline lipid profiles and AF recurrence after AF ablation. Methods: We retrospectively studied patients who underwent AF ablation from January 2016 to September 2021 at two high-volume international centers. Patients with a lipid profile in the previous 24 months prior to AF ablation and a one-year post-ablation follow-up with electrocardiogram were included. AF recurrence was defined as having a 12-lead electrocardiographic evidence of AF or atrial tachycardia within one year after a 3-month blanking period. Logistic regression analysis was performed to examine association of lipid profiles (low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), and triglycerides) with AF recurrence. Lipid profiles were evaluated both as continuous and categorical variables. Well-established cut-points were used for LDL, and tertiles were used for HDL, TC, and triglycerides. Results: A total of 287 patients were included in the study (mean age (SD), 63.6 (10.5), 36% female). Patients with LDL<70 mg/dL or TC < 141 mg/dL had a decreased risk of AF recurrence in unadjusted analysis. These associations remained significant after adjustment by traditional AF risk factors and statin use (odds ratios (ORs) (95% confidence interval): 0.27 (0.09 - 0.79) and 0.28 (0.09 - 0.84), respectively. TC analyzed as a continuous variable was associated with increased risk of AF recurrence (1.012 (1.002 - 1.022) per 1 mg/dL increase). (Table). Conclusions: In our international registry, patients with LDL <70 mg/dL or TC <141 mg/dL were associated with a reduced risk of AF recurrence, suggesting a beneficial effect of low LDL and TC in patients with AF undergoing catheter ablation.
The effect of the mechanical properties of a heterogeneous part on pulse wave has been investigated by using a one-dimensional lattice model associated with the material nonlinearity of the arterial vessel wall (an extended Sakanishi model). In the present study, from the viewpoint of mechanics, a part of blood vessel, which has the different mechanical properties of the arterial vessel wall, that is, a part of arteriosclerosis, prosthesis and so on, is regarded as the heterogeneous part by a generalization. The stability of the solitary wave is applied in order to obtain the reliable results by the numerical analysis of the pulse wave which propagates through the heterogeneous part in the blood vessel. As a result, the behaviors of the pulse wave and the mechanical factors which have the effects on the propagation of the pulse wave are shown. Moreover, a mechanical condition for the appropriate joining of the prosthesis is derived.
Abstract Purpose Low‐dose adenosine triphosphate (LD‐ATP) is useful for diagnosing ATP‐sensitive atrial tachycardia. However, the clinical implications of the sensitivity of LD‐ATP in atrioventricular nodal reentrant tachycardia (AVNRT) still remain unknown. This study aimed to evaluate the mechanism of LD‐ATP sensitivity in slow‐fast AVNRT. Methods We estimated the sensitivity of LD‐ATP in slow‐fast AVNRT by a 2‐4‐mg ATP intravenous injection during the tachycardia. We evaluated the atrial‐His (A‐H) interval, tachycardia termination mode, prevalence of a lower common pathway (LCP), and successful ablation site in slow‐fast AVNRT with LD‐ATP sensitivity. LCPs were defined as His‐atrial interval differences of at least 5 ms between that during ventricular pacing at the tachycardia cycle length and that during the tachycardia. Results Twenty‐eight patients (mean age = 58 ± 11 years old, 18 females) with slow‐fast AVNRT, who underwent catheter ablation of the antegrade slow pathway, were enrolled. Seventeen of 28 (61%) patients had LD‐ATP sensitivity defined as termination of the tachycardia and/or a prolongation of the A‐H interval of over 30 ms after an LD‐ATP injection. The patients with LD‐ATP sensitivity had a significantly higher prevalence of an LCP than those without (15/17 vs0/11, P < 0.0001). The successful ablation site in the LD‐ATP sensitive group was significantly closer to the His bundle area than that in the LD‐ATP nonsensitive group (13.3 ± 3.8 vs 20.5 ± 5.4 mm; distance to His bundle area in the left anterior oblique fluoroscopic view, P < 0.0001). Conclusions LD‐ATP sensitivity in slow‐fast AVNRT may suggest the existence of an LCP. The successful ablation site in patients with LD‐ATP sensitivity could be closer to the His bundle region.
The aim of this study was to compare the differences in the levels of a highly sensitive cardiac troponin T (Hs-cTnT) between Losartan (LOS) plus hydrochlorothiazide (HCTZ) and amlodipine. Seventy-eight hypertensive patients were randomized to receive LOS/HCTZ or amlodipine for 8 weeks. Both treatments decreased clinic and 24-hour blood pressure to the same extent. The Hs-cTnT level was significantly reduced in the amlodipine group (P < .05), but such a reduction was not found in the LOS/HCTZ group in the upper half group of Hs-cTnT level at baseline. Amlodipine had a more beneficial effect than LOS/HCTZ in patients with high Hs-cTnT levels.
Background: The arrhythmogenic substrate in atrial myocardium could contribute the trigger of atrial fibrillation (AF) except pulmonary vein (PV). This study was conducted to investigate the arrhythmogenic substrate using an isochronal late activation mapping (ILAM) related with the trigger of AF. Methods: Forty-five AF patients (age 65±9 years old,35 Males,17 non-paroxysmal AF,11 patients with 2 nd -session procedure) who underwent the catheter ablation for AF were enrolled. The high-density activation mapping of left atrium (LA) was obtained by in sinus rhythm or atrial pacing with a cycle length of 600ms. ILAM was retrospectively constructed and deceleration zone was defined as abnormal conduction area with ≥3 isochrones within a 1cm radius along with a discontinuity of conduction zone. Relationship between the AF arrhythmogenicity and ILAM deceleration zone was investigated. Results: Patients with non-paroxysmal AF has larger number of ILAM deceleration zone in LA than those with paroxysmal AF (median [interquartile], 4.0[2.5-7.5] vs.0[0-5], p=0.028). Of all, 15 patients had a trigger of AF except pulmonary vein (non-PV foci) in the LA (10: posterior wall, 6: anterior wall, 2: septum, 1: roof). Patients with non-PV foci had a larger number of ILAM deceleration zone in LA than those without (median [interquartile], 6.0[4.0-8.0] vs.0[0-4], p<0.001). Furthermore, 15 patients with non-PV foci had 35 deceleration zones in sinus rhythm, 26 of them were associated with non-PV foci. On the other hand, of total 87 deceleration zones in all patients, 61 deceleration zones had no contribution to the non-PV foci. Conclusion: ILAM deceleration zone with ≥3 isochrones within a 1cm radius along with a discontinuity of conduction zone obtained in sinus rhythm may be useful to assess the atrial myocardial arrhythmogenic substrate related with non-PV foci.
