The role of valvular regurgitation in catheter ablation outcomes of patients with long-standing persistent atrial fibrillation

The role of valvular regurgitation (VR) in outcomes of patients obtaining current ablation endpoints with long-standing persistent atrial fibrillation (LS-AF) was evaluated. In all, 216 consecutive patients obtaining current ablation endpoints with LS-AF were studied. A standard two-dimensional and Doppler transthoracic echocardiography (TTE) was performed in every patient before the procedure. The presentation and the grade of mitral regurgitation (MR), tricuspid regurgitation, and aortic regurgitation were evaluated. The clinical characteristics, TTE, and procedural characteristics were compared between the sinus rhythm group and the recurrent atrial tachyarrhythmia (ATa) group. After a follow-up of 18.9 +/- 2.7 months, there were 48 patients in the ATa group. The patients in the ATa group had greater MR, longer AF duration, and larger left atrium (LA). In multivariate analyses, MR, LA size, and AF duration were independent predictors of recurrent ATa. The grades of MR severity were correlated with the rate of recurrent ATa, and more severe grade of MR indicated more recurrent ATa. Compared with the patients with organic MR, the patients with functional MR had a lower rate of recurrent ATa and lesser degrees of MR. In the three types of VR, MR was associated with recurrent ATa after AF ablation. Patients with ATa recurrence had more severe MR and greater organic MR.