LAUSR

Atrial functional mitral regurgitation (AF-MR) related to atrial fibrillation (AF) could affect the effectiveness of the sinus rhythm restoring procedures. The aim of the study was to evaluate the impact of AF-MR on pulmonary vein isolation (PVI) efficacy. One hundred thirty-six patients (65.4% males; mean age 56±11 years) with symptomatic paroxysmal or persistent AF qualified for PVI were enrolled into the study. AF-MR assessment was performed in transthoracic (TTE) and transesophageal (TEE) echocardiography before PVI procedure. PVI efficacy was evaluated in 3-month and long-term follow-up. AF-MR was diagnosed in 74.3% patient in transthoracic echocardiography (TTE) (trace: 26.5%, mild: 43.4%, moderate: 3.7%, severe 0.7%) and 94.9% in transesophageal echocardiography (TEE) (trace: 17.6%, mild: 59.6%, moderate: 16.2%, severe: 1.5%). PVI 3-month efficacy was 75.7% in 3-month and 64% in the long-term observation. Severe AF-MR in TEE at baseline was associated with lower 3-month PVI efficacy (P=0.012) while moderate to severe AF MR in TEE was related to inefficient PVI assessed in long-term follow-up (P=0.041). In Kaplan- Meier analysis only moderate to severe AF-MR diagnosed in TEE had an impact on long-term procedure outcome (P=0.048). Significant AF-MR confirmed by TEE predicts 3-month as well as long-term PVI efficacy. Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The institutional budget of the First Department of Cardiology, Medical University of Silesia, Katowice, Poland