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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

Piotr Gardziejczyk1, Michał M Farkowski1, Mariusz Pytkowsk1, Karol Kołakowski1, Ilona Kowalik2, Przemysław Leszek3, Krzysztof Jaworski4, Aleksandra Wróbel5, Aleksander Maciąg1
DOI: 10.33963/KP.a2022.0057
·
Pubmed: 35188219
Affiliations
  1. 2nd Department of Heart Arrhythmia, National Institute of Cardiology, Warszawa, Poland
  2. Clinical Research Support Center, National Institute of Cardiology, Warszawa, Poland
  3. Department of Heart Failure and Transplantology, National Institute of Cardiology, Warszawa, Poland
  4. Department of Coronary Artery Disease and Cardiac Rehabilitation, National Institute of Cardiology, Warszawa, Poland
  5. Department of Medical Biology, National Institute of Cardiology, Warszawa, Poland

open access

Online first
Original article
Published online: 2022-02-21

Abstract

Background: 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).

Aims: 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.

Methods: 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.

Results: 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]; P <0.001), EQ5D-3L Score (mean [standard deviation], 21.8 (16.8); P <0.001); EQ5D-3L index (median [IQR], 0.09 (0.05;0.18); p <0.001). A significant decrease in injury biomarkers: NT-proBNP (median [IQR], –414 [–1397;–318] pg/ml; P <0.001), TnT (median [IQR], –2.27 (–8.52;0.55) ng/ml; P <0.01) 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]; P <0.01).

Conclusions: Successful CA significantly improved clinical status, LVEF and HRQoL of patients with SHD and AMC.

Abstract

Background: 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).

Aims: 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.

Methods: 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.

Results: 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]; P <0.001), EQ5D-3L Score (mean [standard deviation], 21.8 (16.8); P <0.001); EQ5D-3L index (median [IQR], 0.09 (0.05;0.18); p <0.001). A significant decrease in injury biomarkers: NT-proBNP (median [IQR], –414 [–1397;–318] pg/ml; P <0.001), TnT (median [IQR], –2.27 (–8.52;0.55) ng/ml; P <0.01) 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]; P <0.01).

Conclusions: Successful CA significantly improved clinical status, LVEF and HRQoL of patients with SHD and AMC.

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Keywords

arrhythmia-mediated cardiomyopathy, biomarkers, catheter ablation, quality of life, structural heart disease

About this article
Title

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

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2022-02-21

Page views

75

Article views/downloads

44

DOI

10.33963/KP.a2022.0057

Pubmed

35188219

Keywords

arrhythmia-mediated cardiomyopathy
biomarkers
catheter ablation
quality of life
structural heart disease

Authors

Piotr Gardziejczyk
Michał M Farkowski
Mariusz Pytkowsk
Karol Kołakowski
Ilona Kowalik
Przemysław Leszek
Krzysztof Jaworski
Aleksandra Wróbel
Aleksander Maciąg

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