Differentiating Left Atrial Pressure Responses in Paroxysmal and Persistent Atrial Fibrillation: Implications for Diagnosing Heart Failure With Preserved Ejection Fraction and Managing Atrial Fibrillation

Increased left atrial pressure (LAP) contributes to dyspnea and heart failure with preserved ejection fraction in patients with atrial fibrillation (AF). The purpose of this study was to investigate the differences in baseline LAP and LAP response to rapid pacing between paroxysmal and persistent AF...

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Bibliographic Details
Published in:Journal of the American Heart Association 2024-09, Vol.13 (17), p.e035246
Main Authors: Park, Jong Sung, Cho, Iksung, Kim, Daehoon, Kim, Moon-Hyun, Park, Je-Wook, Yu, Hee Tae, Kim, Tae-Hoon, Uhm, Jae-Sun, Joung, Boyoung, Lee, Moon-Hyoung, Pak, Hui-Nam
Format: Article
Language:English
Subjects:
Aged
atrial fibrillation
Atrial Fibrillation - diagnosis
Atrial Fibrillation - physiopathology
Atrial Fibrillation - surgery
Atrial Fibrillation - therapy
Atrial Function, Left - physiology
Atrial Pressure - physiology
Cardiac Pacing, Artificial
Catheter Ablation
Echocardiography
Female
H2FPEF score
Heart Failure - diagnosis
Heart Failure - physiopathology
Heart Failure - therapy
Heart Rate - physiology
Humans
isoproterenol
Isoproterenol - administration & dosage
left atrial pressure
Male
Middle Aged
Original Research
pacing
Prospective Studies
Stroke Volume - physiology
Ventricular Function, Left - physiology
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Summary:Increased left atrial pressure (LAP) contributes to dyspnea and heart failure with preserved ejection fraction in patients with atrial fibrillation (AF). The purpose of this study was to investigate the differences in baseline LAP and LAP response to rapid pacing between paroxysmal and persistent AF. This observational study prospectively enrolled 1369 participants who underwent AF catheter ablation, excluding those with reduced left ventricular ejection fraction. H FPEF score was calculated by echocardiography and baseline characteristics. Patients underwent LAP measurements during AF, sinus rhythm, and heart rates of 90, 100, 110, and 120 beats per minute (bpm), induced by right atrial pacing and isoproterenol. The baseline LAP-peak in the persistent AF group consistently exceeded that in the paroxysmal AF (PAF) group across each H FPEF score subgroup (all
ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.124.035246