Predictor of atrial fibrillation recurrence in patients who underwent a tricuspid valve operation with modified Cox maze procedure
Background Recurrence of any atrial arrhythmia after surgical ablation is known as a negative predictor of cardiovascular events and total mortality. However, there have been no focused studies for atrial fibrillation (AF) recurrence prediction in patients with significant tricuspid regurgitation (T...
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| Veröffentlicht in: | Echocardiography (Mount Kisco, N.Y.) N.Y.), 2022-03, Vol.39 (3), p.447-456 |
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| creator | Bak, Minjung Jeong, Dong Seop Park, Sung‐Ji Park, Boram Seo, Jeong Hun Park, Ilkun Kim, Jihoon Chung, Su Ryeun Kim, Eun Kyoung Sung, Kiick |
| description | Background
Recurrence of any atrial arrhythmia after surgical ablation is known as a negative predictor of cardiovascular events and total mortality. However, there have been no focused studies for atrial fibrillation (AF) recurrence prediction in patients with significant tricuspid regurgitation (TR), and the risk‐benefit estimation of surgical ablation in tricuspid valve (TV) surgery is not fully established.
Method
We screened 385 patients who underwent a TV operation between 2001 and 2017. After excluding patients who did not undergo a maze operation, 158 patients were enrolled. Enrolled patients were divided by recurrence of AF. We analyzed the difference between the AF recurrence group and no AF recurrence group, and AF recurrence factors in terms of clinical risk factors and echocardiographic risk factors. The hazard ratio (HR) and 95% confidence intervals (CIs) were presented using a Cox proportional hazard model.
Results
Among 158 patients, AF recurred in 65 patients within 10 years. For AF prediction, age was most the important clinical factor and right atrium (RA) diameter was the most important echocardiographic parameters. In patients with a larger RA diameter over 49.2 mm, the prevalence of AF recurrence was higher (HR 4.322, 95% CI [2.185–8.549], log rank p value |
| doi_str_mv | 10.1111/echo.15315 |
| format | Article |
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Recurrence of any atrial arrhythmia after surgical ablation is known as a negative predictor of cardiovascular events and total mortality. However, there have been no focused studies for atrial fibrillation (AF) recurrence prediction in patients with significant tricuspid regurgitation (TR), and the risk‐benefit estimation of surgical ablation in tricuspid valve (TV) surgery is not fully established.
Method
We screened 385 patients who underwent a TV operation between 2001 and 2017. After excluding patients who did not undergo a maze operation, 158 patients were enrolled. Enrolled patients were divided by recurrence of AF. We analyzed the difference between the AF recurrence group and no AF recurrence group, and AF recurrence factors in terms of clinical risk factors and echocardiographic risk factors. The hazard ratio (HR) and 95% confidence intervals (CIs) were presented using a Cox proportional hazard model.
Results
Among 158 patients, AF recurred in 65 patients within 10 years. For AF prediction, age was most the important clinical factor and right atrium (RA) diameter was the most important echocardiographic parameters. In patients with a larger RA diameter over 49.2 mm, the prevalence of AF recurrence was higher (HR 4.322, 95% CI [2.185–8.549], log rank p value < .001). In clinical outcome, there was no significant difference between the AF recurrence group and the no recurrence group in terms of death, TR recurrence, heart failure, and stroke. However, the risk of permanent pacemaker (PPM) insertion was higher in the AF recurrence group (HR 10.240, 95% CI [1.257–83.480], log rank p value .007) compared to the no recurrence group.
Conclusion
Age and RA enlargement are key predictors of AF recurrence after TV operation with the CM procedure in patients with significant TR.</description><identifier>ISSN: 0742-2822</identifier><identifier>EISSN: 1540-8175</identifier><identifier>DOI: 10.1111/echo.15315</identifier><identifier>PMID: 35165935</identifier><language>eng</language><publisher>United States</publisher><subject>Age Factors ; atrial fibrillation ; Atrial Fibrillation - diagnostic imaging ; Atrial Fibrillation - etiology ; Atrial Fibrillation - surgery ; Catheter Ablation - adverse effects ; Catheter Ablation - methods ; Echocardiography ; Heart Atria - diagnostic imaging ; Heart Atria - pathology ; Heart Atria - surgery ; Humans ; maze ; Maze Procedure - adverse effects ; Maze Procedure - methods ; Organ Size ; Recurrence ; Retrospective Studies ; right atrium diameter ; Risk Assessment ; Risk Factors ; structural heart disease ; Treatment Outcome ; Tricuspid Valve - diagnostic imaging ; Tricuspid Valve - surgery ; Tricuspid Valve Insufficiency - complications ; Tricuspid Valve Insufficiency - diagnostic imaging ; Tricuspid Valve Insufficiency - surgery ; tricuspid valve operation</subject><ispartof>Echocardiography (Mount Kisco, N.Y.), 2022-03, Vol.39 (3), p.447-456</ispartof><rights>2022 Wiley Periodicals LLC</rights><rights>2022 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3655-b0e8234565b1b7e35d0677e1d2f59340f3cc1148b00fa6089c66b3cf634685543</citedby><cites>FETCH-LOGICAL-c3655-b0e8234565b1b7e35d0677e1d2f59340f3cc1148b00fa6089c66b3cf634685543</cites><orcidid>0000-0003-3345-2516</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fecho.15315$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fecho.15315$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35165935$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bak, Minjung</creatorcontrib><creatorcontrib>Jeong, Dong Seop</creatorcontrib><creatorcontrib>Park, Sung‐Ji</creatorcontrib><creatorcontrib>Park, Boram</creatorcontrib><creatorcontrib>Seo, Jeong Hun</creatorcontrib><creatorcontrib>Park, Ilkun</creatorcontrib><creatorcontrib>Kim, Jihoon</creatorcontrib><creatorcontrib>Chung, Su Ryeun</creatorcontrib><creatorcontrib>Kim, Eun Kyoung</creatorcontrib><creatorcontrib>Sung, Kiick</creatorcontrib><title>Predictor of atrial fibrillation recurrence in patients who underwent a tricuspid valve operation with modified Cox maze procedure</title><title>Echocardiography (Mount Kisco, N.Y.)</title><addtitle>Echocardiography</addtitle><description>Background
Recurrence of any atrial arrhythmia after surgical ablation is known as a negative predictor of cardiovascular events and total mortality. However, there have been no focused studies for atrial fibrillation (AF) recurrence prediction in patients with significant tricuspid regurgitation (TR), and the risk‐benefit estimation of surgical ablation in tricuspid valve (TV) surgery is not fully established.
Method
We screened 385 patients who underwent a TV operation between 2001 and 2017. After excluding patients who did not undergo a maze operation, 158 patients were enrolled. Enrolled patients were divided by recurrence of AF. We analyzed the difference between the AF recurrence group and no AF recurrence group, and AF recurrence factors in terms of clinical risk factors and echocardiographic risk factors. The hazard ratio (HR) and 95% confidence intervals (CIs) were presented using a Cox proportional hazard model.
Results
Among 158 patients, AF recurred in 65 patients within 10 years. For AF prediction, age was most the important clinical factor and right atrium (RA) diameter was the most important echocardiographic parameters. In patients with a larger RA diameter over 49.2 mm, the prevalence of AF recurrence was higher (HR 4.322, 95% CI [2.185–8.549], log rank p value < .001). In clinical outcome, there was no significant difference between the AF recurrence group and the no recurrence group in terms of death, TR recurrence, heart failure, and stroke. However, the risk of permanent pacemaker (PPM) insertion was higher in the AF recurrence group (HR 10.240, 95% CI [1.257–83.480], log rank p value .007) compared to the no recurrence group.
Conclusion
Age and RA enlargement are key predictors of AF recurrence after TV operation with the CM procedure in patients with significant TR.</description><subject>Age Factors</subject><subject>atrial fibrillation</subject><subject>Atrial Fibrillation - diagnostic imaging</subject><subject>Atrial Fibrillation - etiology</subject><subject>Atrial Fibrillation - surgery</subject><subject>Catheter Ablation - adverse effects</subject><subject>Catheter Ablation - methods</subject><subject>Echocardiography</subject><subject>Heart Atria - diagnostic imaging</subject><subject>Heart Atria - pathology</subject><subject>Heart Atria - surgery</subject><subject>Humans</subject><subject>maze</subject><subject>Maze Procedure - adverse effects</subject><subject>Maze Procedure - methods</subject><subject>Organ Size</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>right atrium diameter</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>structural heart disease</subject><subject>Treatment Outcome</subject><subject>Tricuspid Valve - diagnostic imaging</subject><subject>Tricuspid Valve - surgery</subject><subject>Tricuspid Valve Insufficiency - complications</subject><subject>Tricuspid Valve Insufficiency - diagnostic imaging</subject><subject>Tricuspid Valve Insufficiency - surgery</subject><subject>tricuspid valve operation</subject><issn>0742-2822</issn><issn>1540-8175</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtKxDAUhoMoOl42PoBkKUI1lybtLGXwBoIudF3S5ISJtE1NWkdd-uRm7OjSbA4J3_nC_yN0TMk5TecC9NKfU8Gp2EIzKnKSlbQQ22hGipxlrGRsD-3H-EIIKSjNd9EeF1SKORcz9PUYwDg9-IC9xWoITjXYujq4plGD8x0OoMcQoNOAXYf79AjdEPFq6fHYGQirdMUKp009xt4Z_KaaN8C-hzAJVm5Y4tYbZx0YvPDvuFWfgPvgNZgxwCHasaqJcLSZB-j5-uppcZvdP9zcLS7vM82lEFlNoGQ8F1LUtC6AC0NkUQA1zKYoObFc65SurAmxSpJyrqWsubaS57IUIucH6HTypp9fR4hD1bqoIeXswI-xYpLNiZgzJhN6NqE6-BgD2KoPrlXho6KkWnderTuvfjpP8MnGO9YtmD_0t-QE0AlYuQY-_lFVV4vbh0n6DYQQje8</recordid><startdate>202203</startdate><enddate>202203</enddate><creator>Bak, Minjung</creator><creator>Jeong, Dong Seop</creator><creator>Park, Sung‐Ji</creator><creator>Park, Boram</creator><creator>Seo, Jeong Hun</creator><creator>Park, Ilkun</creator><creator>Kim, Jihoon</creator><creator>Chung, Su Ryeun</creator><creator>Kim, Eun Kyoung</creator><creator>Sung, Kiick</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3345-2516</orcidid></search><sort><creationdate>202203</creationdate><title>Predictor of atrial fibrillation recurrence in patients who underwent a tricuspid valve operation with modified Cox maze procedure</title><author>Bak, Minjung ; Jeong, Dong Seop ; Park, Sung‐Ji ; Park, Boram ; Seo, Jeong Hun ; Park, Ilkun ; Kim, Jihoon ; Chung, Su Ryeun ; Kim, Eun Kyoung ; Sung, Kiick</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3655-b0e8234565b1b7e35d0677e1d2f59340f3cc1148b00fa6089c66b3cf634685543</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Age Factors</topic><topic>atrial fibrillation</topic><topic>Atrial Fibrillation - diagnostic imaging</topic><topic>Atrial Fibrillation - etiology</topic><topic>Atrial Fibrillation - surgery</topic><topic>Catheter Ablation - adverse effects</topic><topic>Catheter Ablation - methods</topic><topic>Echocardiography</topic><topic>Heart Atria - diagnostic imaging</topic><topic>Heart Atria - pathology</topic><topic>Heart Atria - surgery</topic><topic>Humans</topic><topic>maze</topic><topic>Maze Procedure - adverse effects</topic><topic>Maze Procedure - methods</topic><topic>Organ Size</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>right atrium diameter</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>structural heart disease</topic><topic>Treatment Outcome</topic><topic>Tricuspid Valve - diagnostic imaging</topic><topic>Tricuspid Valve - surgery</topic><topic>Tricuspid Valve Insufficiency - complications</topic><topic>Tricuspid Valve Insufficiency - diagnostic imaging</topic><topic>Tricuspid Valve Insufficiency - surgery</topic><topic>tricuspid valve operation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bak, Minjung</creatorcontrib><creatorcontrib>Jeong, Dong Seop</creatorcontrib><creatorcontrib>Park, Sung‐Ji</creatorcontrib><creatorcontrib>Park, Boram</creatorcontrib><creatorcontrib>Seo, Jeong Hun</creatorcontrib><creatorcontrib>Park, Ilkun</creatorcontrib><creatorcontrib>Kim, Jihoon</creatorcontrib><creatorcontrib>Chung, Su Ryeun</creatorcontrib><creatorcontrib>Kim, Eun Kyoung</creatorcontrib><creatorcontrib>Sung, Kiick</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bak, Minjung</au><au>Jeong, Dong Seop</au><au>Park, Sung‐Ji</au><au>Park, Boram</au><au>Seo, Jeong Hun</au><au>Park, Ilkun</au><au>Kim, Jihoon</au><au>Chung, Su Ryeun</au><au>Kim, Eun Kyoung</au><au>Sung, Kiick</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictor of atrial fibrillation recurrence in patients who underwent a tricuspid valve operation with modified Cox maze procedure</atitle><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle><addtitle>Echocardiography</addtitle><date>2022-03</date><risdate>2022</risdate><volume>39</volume><issue>3</issue><spage>447</spage><epage>456</epage><pages>447-456</pages><issn>0742-2822</issn><eissn>1540-8175</eissn><abstract>Background
Recurrence of any atrial arrhythmia after surgical ablation is known as a negative predictor of cardiovascular events and total mortality. However, there have been no focused studies for atrial fibrillation (AF) recurrence prediction in patients with significant tricuspid regurgitation (TR), and the risk‐benefit estimation of surgical ablation in tricuspid valve (TV) surgery is not fully established.
Method
We screened 385 patients who underwent a TV operation between 2001 and 2017. After excluding patients who did not undergo a maze operation, 158 patients were enrolled. Enrolled patients were divided by recurrence of AF. We analyzed the difference between the AF recurrence group and no AF recurrence group, and AF recurrence factors in terms of clinical risk factors and echocardiographic risk factors. The hazard ratio (HR) and 95% confidence intervals (CIs) were presented using a Cox proportional hazard model.
Results
Among 158 patients, AF recurred in 65 patients within 10 years. For AF prediction, age was most the important clinical factor and right atrium (RA) diameter was the most important echocardiographic parameters. In patients with a larger RA diameter over 49.2 mm, the prevalence of AF recurrence was higher (HR 4.322, 95% CI [2.185–8.549], log rank p value < .001). In clinical outcome, there was no significant difference between the AF recurrence group and the no recurrence group in terms of death, TR recurrence, heart failure, and stroke. However, the risk of permanent pacemaker (PPM) insertion was higher in the AF recurrence group (HR 10.240, 95% CI [1.257–83.480], log rank p value .007) compared to the no recurrence group.
Conclusion
Age and RA enlargement are key predictors of AF recurrence after TV operation with the CM procedure in patients with significant TR.</abstract><cop>United States</cop><pmid>35165935</pmid><doi>10.1111/echo.15315</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-3345-2516</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Echocardiography (Mount Kisco, N.Y.), 2022-03, Vol.39 (3), p.447-456 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Age Factors atrial fibrillation Atrial Fibrillation - diagnostic imaging Atrial Fibrillation - etiology Atrial Fibrillation - surgery Catheter Ablation - adverse effects Catheter Ablation - methods Echocardiography Heart Atria - diagnostic imaging Heart Atria - pathology Heart Atria - surgery Humans maze Maze Procedure - adverse effects Maze Procedure - methods Organ Size Recurrence Retrospective Studies right atrium diameter Risk Assessment Risk Factors structural heart disease Treatment Outcome Tricuspid Valve - diagnostic imaging Tricuspid Valve - surgery Tricuspid Valve Insufficiency - complications Tricuspid Valve Insufficiency - diagnostic imaging Tricuspid Valve Insufficiency - surgery tricuspid valve operation |
| title | Predictor of atrial fibrillation recurrence in patients who underwent a tricuspid valve operation with modified Cox maze procedure |
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