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A quality of life, clinical and biochemical improvements after catheter ablation of persistent arrhythmia in patients with structural heart disease and arrhythmia-mediated cardiomyopathy

A quality of life, clinical and biochemical improvements after catheter ablation of persistent arrhythmia in patients with structural heart disease and arrhythmia-mediated cardiomyopathy

Authors :
Piotr Gardziejczyk
Michał M Farkowski
Mariusz Pytkowski
Karol Kołakowski
Ilona Kowalik
Przemysław Leszek
Krzysztof Jaworski
Aleksandra Wróbel
Aleksander Maciąg
Source :
Kardiologia polska.
Publication Year :
2022

Abstract

Arrhythmia-mediated cardiomyopathy (AMC) is an essential clinical situation which is commonly underdiagnosed. Successful arrhythmia control leads to improvement in health-related quality of life (HRQoL) and heart failure (HF) symptoms in patients with structural heart disease (SHD).The aim of the study was to evaluate the impact of catheter ablation (CA) of persistent arrhythmia on HRQoL, biochemical and clinical parameters HF in patients with SHD and AMC.Patients with SHD, on optimal medical treatment, with persistent arrhythmia and strong suspicion of AMC, scheduled for CA were prospectively enrolled. Study procedures included: HRQoL measurement (Minnesota Living With Heart Failure Questionnaire [MLHFQ] and EuroQol Research Foundation [EQ-5D-3L] questionnaire), biomarkers (N-terminal pro-B-type natriuretic peptide [NT-proBNP], troponin T [TnT], matrix metaloproteinase-9 [MMP-9], soluble suppression of tumorigenesis-2 [sST2], tissue inhibitor of matrix metalloproteinase-1 [TIMP-1]), transthoracic echocardiography and clinical assessment.At 6 months, 30/35 (86%) patients were free of persistent arrhythmia. Patients who underwent successful CA had a significant improvement in HRQoL: MLHFQ (median [interquartile range, IQR], -22 [-28;-11]; P0.001), EQ5D-3L Score (mean [standard deviation], 21.8 (16.8); P0.001); EQ5D-3L index (median [IQR], 0.09 (0.05;0.18); p0.001). A significant decrease in injury biomarkers: NT-proBNP (median [IQR], -414 [-1397;-318] pg/ml; P0.001), TnT (median [IQR], -2.27 (-8.52;0.55) ng/ml; P0.01) but not fibrosis biomarkers (median [IQR], sST2: 2.20 [-5.4;4.3] ng/ml; P = 0.741, MMP-9: 34 [-376;283] ng/ml; P = 0.881, TIMP-1: 11.1 [-17.1;31.9] ng/ml; P = 0.215) was observed. There was a significant increase of left ventricular ejection fraction (LVEF) (mean [SD], 9.8 [5.9]; P0.01).Successful CA significantly improved clinical status, LVEF and HRQoL of patients with SHD and AMC.

Details

ISSN :
18974279
Database :
OpenAIRE
Journal :
Kardiologia polska
Accession number :
edsair.doi.dedup.....8d5a154e1f555b0ed7bb647d7c50bb30