Age, arrhythmia recurrence predict tricuspid regurgitation improvement after AF ablation
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Key takeaways:
- Age and lack of arrhythmia recurrence are predictors of tricuspid regurgitation improvement after catheter ablation for AF.
- Tricuspid regurgitation improvement is tied to better outcomes at 1 year.
Among older adults who underwent catheter ablation for persistent atrial fibrillation, younger age and absence of late recurrence were good predictors of improvement of tricuspid regurgitation, which was tied to better outcomes, data show.
“In this study, the improvement group had the higher incidence of major event‐free survival than the non-improvement group,” Masami Nishino, MD, PhD, FACC, FESC, of the division of cardiology at Osaka Rosai Hospital, Japan, and colleagues wrote. “In other words, in the patients with persistent AF and moderate or severe tricuspid regurgitation, catheter ablation might be helpful for decreasing the major event if tricuspid regurgitation is improved.”
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In a retrospective, observational study, Nishino and colleagues analyzed data from 141 patients with persistent AF and moderate or severe tricuspid regurgitation assessed by transthoracic echocardiography. Patients underwent an initial radiofrequency catheter ablation between February 2015 and August 2021. Patients then underwent follow-up transthoracic echocardiography at 12 months and were categorized into two groups based on improvement (defined as at least one‐grade improvement of tricuspid regurgitation) and non‐improvement of tricuspid regurgitation. Researchers compared patient characteristics, ablation procedures and recurrences after radiofrequency catheter ablation between the two groups and also assessed major events, defined as admission for HF or all-cause death more than 12 months after the ablation.
The findings were published in the Journal of Cardiovascular Electrophysiology.
Within the cohort, 64% of patients had at least one-grade improvement in tricuspid regurgitation. Patients with improvement were younger (mean age, 72 years vs. 75 years; P = .02) and were more likely to be men vs. women (61.1% vs. 43.1%; P = .039).
Researchers found that being younger than 71 years (OR = 3.8; 95% CI, 1.49-11.1; P = .004) and absence of late recurrence, defined as recurrence of atrial tachyarrhythmia between 3 and 12 months after the ablation (OR = 2.61; 95% CI, 1.08-6.49; P = .034), were independent predictors of improvement of tricuspid regurgitation after undergoing ablation. Additionally, tricuspid regurgitation improvement was associated with better clinical outcomes.
“Relatively young age and absence of late recurrence were good predictors of improvement of tricuspid regurgitation after the radiofrequency catheter ablation for persistent AF,” the researchers wrote. “Furthermore, the improvement of tricuspid regurgitation was related to better clinical outcomes.”
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