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The effect of open-irrigated radiofrequency catheter ablation of atrial fibrillation on left atrial pressure and B-type natriuretic peptide

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The effect of open-irrigated radiofrequency catheter ablation of atrial fibrillation on left atrial pressure and B-type natriuretic peptide. / Seiler, Jens; Steven, Daniel; Roberts-Thomson, Kurt C; Inada, Keiichi; Tedrow, Usha B; Michaud, Gregory F; Stevenson, William G.

In: PACE, Vol. 37, No. 5, 05.2014, p. 616-623.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Seiler, J, Steven, D, Roberts-Thomson, KC, Inada, K, Tedrow, UB, Michaud, GF & Stevenson, WG 2014, 'The effect of open-irrigated radiofrequency catheter ablation of atrial fibrillation on left atrial pressure and B-type natriuretic peptide', PACE, vol. 37, no. 5, pp. 616-623. https://doi.org/10.1111/pace.12329

APA

Seiler, J., Steven, D., Roberts-Thomson, K. C., Inada, K., Tedrow, U. B., Michaud, G. F., & Stevenson, W. G. (2014). The effect of open-irrigated radiofrequency catheter ablation of atrial fibrillation on left atrial pressure and B-type natriuretic peptide. PACE, 37(5), 616-623. https://doi.org/10.1111/pace.12329

Vancouver

Seiler J, Steven D, Roberts-Thomson KC, Inada K, Tedrow UB, Michaud GF et al. The effect of open-irrigated radiofrequency catheter ablation of atrial fibrillation on left atrial pressure and B-type natriuretic peptide. PACE. 2014 May;37(5):616-623. https://doi.org/10.1111/pace.12329

Bibtex

@article{80eec805b90643ceac1f4c0f1f5a65b2,
title = "The effect of open-irrigated radiofrequency catheter ablation of atrial fibrillation on left atrial pressure and B-type natriuretic peptide",
abstract = "BACKGROUND: Open-irrigated radiofrequency catheter ablation (oiRFA) of atrial fibrillation (AF) imposes a volume load and risk of pulmonary edema. We sought to assess the effect of volume administration during ablation on left atrial (LA) pressure and B-type natriuretic peptide (BNP).METHODS: LA pressure was measured via transseptal sheath at the beginning and end of 44 LA ablation procedures in 42 patients. BNP plasma levels were measured before and after 10 procedures.RESULTS: A median of 3,255 (interquartile range [IQR], 2,014)-mL saline was administered during the procedure. During LA ablation, the median fluid balance was +1,438 (IQR, 1,109) mL and LA pressure increased by median 3.7 (IQR, 5.9) mm Hg (P < 0.001). LA pressure did not change in the 19 procedures with furosemide administration (median ΔP = -0.3 [IQR, 7.1] mm Hg, P = 0.334). The correlation of LA pressure and fluid balance was weak (rs = 0.383, P = 0.021). BNP decreased in all four procedures starting in AF or atrial tachycardia and then converting to sinus rhythm (P = 0.068), and increased in all six procedures starting and finishing in sinus rhythm (P = 0.028). After ablation, symptomatic volume overload responding to diuresis occurred in three patients.CONCLUSIONS: A substantial intravascular volume load during oiRFA can be absorbed with little change in LA pressure, such that LA pressure is not a reliable indicator of the fluid balance. Subsequent redistribution of the volume load imposes a risk after the procedure. Conversion to sinus rhythm may improve ability to acutely accommodate the volume load.",
keywords = "Atrial Fibrillation/complications, Atrial Pressure, Catheter Ablation/adverse effects, Female, Humans, Male, Middle Aged, Natriuretic Peptide, Brain/blood, Reproducibility of Results, Sensitivity and Specificity, Therapeutic Irrigation/adverse effects, Treatment Outcome, Water-Electrolyte Imbalance/diagnosis",
author = "Jens Seiler and Daniel Steven and Roberts-Thomson, {Kurt C} and Keiichi Inada and Tedrow, {Usha B} and Michaud, {Gregory F} and Stevenson, {William G}",
note = "{\textcopyright}2013 Wiley Periodicals, Inc.",
year = "2014",
month = may,
doi = "10.1111/pace.12329",
language = "English",
volume = "37",
pages = "616--623",
journal = "PACE",
issn = "0147-8389",
publisher = "Wiley-Blackwell",
number = "5",

}

RIS

TY - JOUR

T1 - The effect of open-irrigated radiofrequency catheter ablation of atrial fibrillation on left atrial pressure and B-type natriuretic peptide

AU - Seiler, Jens

AU - Steven, Daniel

AU - Roberts-Thomson, Kurt C

AU - Inada, Keiichi

AU - Tedrow, Usha B

AU - Michaud, Gregory F

AU - Stevenson, William G

N1 - ©2013 Wiley Periodicals, Inc.

PY - 2014/5

Y1 - 2014/5

N2 - BACKGROUND: Open-irrigated radiofrequency catheter ablation (oiRFA) of atrial fibrillation (AF) imposes a volume load and risk of pulmonary edema. We sought to assess the effect of volume administration during ablation on left atrial (LA) pressure and B-type natriuretic peptide (BNP).METHODS: LA pressure was measured via transseptal sheath at the beginning and end of 44 LA ablation procedures in 42 patients. BNP plasma levels were measured before and after 10 procedures.RESULTS: A median of 3,255 (interquartile range [IQR], 2,014)-mL saline was administered during the procedure. During LA ablation, the median fluid balance was +1,438 (IQR, 1,109) mL and LA pressure increased by median 3.7 (IQR, 5.9) mm Hg (P < 0.001). LA pressure did not change in the 19 procedures with furosemide administration (median ΔP = -0.3 [IQR, 7.1] mm Hg, P = 0.334). The correlation of LA pressure and fluid balance was weak (rs = 0.383, P = 0.021). BNP decreased in all four procedures starting in AF or atrial tachycardia and then converting to sinus rhythm (P = 0.068), and increased in all six procedures starting and finishing in sinus rhythm (P = 0.028). After ablation, symptomatic volume overload responding to diuresis occurred in three patients.CONCLUSIONS: A substantial intravascular volume load during oiRFA can be absorbed with little change in LA pressure, such that LA pressure is not a reliable indicator of the fluid balance. Subsequent redistribution of the volume load imposes a risk after the procedure. Conversion to sinus rhythm may improve ability to acutely accommodate the volume load.

AB - BACKGROUND: Open-irrigated radiofrequency catheter ablation (oiRFA) of atrial fibrillation (AF) imposes a volume load and risk of pulmonary edema. We sought to assess the effect of volume administration during ablation on left atrial (LA) pressure and B-type natriuretic peptide (BNP).METHODS: LA pressure was measured via transseptal sheath at the beginning and end of 44 LA ablation procedures in 42 patients. BNP plasma levels were measured before and after 10 procedures.RESULTS: A median of 3,255 (interquartile range [IQR], 2,014)-mL saline was administered during the procedure. During LA ablation, the median fluid balance was +1,438 (IQR, 1,109) mL and LA pressure increased by median 3.7 (IQR, 5.9) mm Hg (P < 0.001). LA pressure did not change in the 19 procedures with furosemide administration (median ΔP = -0.3 [IQR, 7.1] mm Hg, P = 0.334). The correlation of LA pressure and fluid balance was weak (rs = 0.383, P = 0.021). BNP decreased in all four procedures starting in AF or atrial tachycardia and then converting to sinus rhythm (P = 0.068), and increased in all six procedures starting and finishing in sinus rhythm (P = 0.028). After ablation, symptomatic volume overload responding to diuresis occurred in three patients.CONCLUSIONS: A substantial intravascular volume load during oiRFA can be absorbed with little change in LA pressure, such that LA pressure is not a reliable indicator of the fluid balance. Subsequent redistribution of the volume load imposes a risk after the procedure. Conversion to sinus rhythm may improve ability to acutely accommodate the volume load.

KW - Atrial Fibrillation/complications

KW - Atrial Pressure

KW - Catheter Ablation/adverse effects

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Natriuretic Peptide, Brain/blood

KW - Reproducibility of Results

KW - Sensitivity and Specificity

KW - Therapeutic Irrigation/adverse effects

KW - Treatment Outcome

KW - Water-Electrolyte Imbalance/diagnosis

U2 - 10.1111/pace.12329

DO - 10.1111/pace.12329

M3 - SCORING: Journal article

C2 - 24372302

VL - 37

SP - 616

EP - 623

JO - PACE

JF - PACE

SN - 0147-8389

IS - 5

ER -