Correlation of the peak oxygen consumption and ventilatory aerobic threshold by cardiopulmonary exercise testing with atrial fibrillation recurrences after ablation in patients with paroxysmal atrial fibrillation

• Published in: Journal of arrhythmia Vol. 36; no. 3; pp. 456 - 463
• Main Authors: Yamashita, Daiki, Kamikawa, Shigeshi, Tanaka, Ryou, Tabita, Natsumi, Nishimura, Saori, Mitsuoka, Miyuki, Higashiya, Shunich, Yamaji, Hirosuke, Murakami, Takashi, Hina, Kazuyoshi, Kusachi, Shozo
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.06.2020; John Wiley and Sons Inc; Wiley
• Subjects: Ablation; Ablation (Surgery); Anaerobic threshold; Atrial fibrillation; Cardiac arrhythmia; cardiopulmonary function; Care and treatment; Catheters; Diseases; Electrocardiography; Exercise; Heart; irrigated catheter; Laboratories; Original; outcome; Patients; percutaneous catheter treatment; Physical fitness; radiofrequency energy; Relapse; reoccurrence; supraventricular tachyarrhythmia; Tachycardia; Value-added tax; Ventilation; Taiwan; supraventricular tachyarrhythmia; percutaneous catheter treatment; radiofrequency energy; reoccurrence; irrigated catheter; exercise; cardiopulmonary function; outcome
• ISSN: 1880-4276; 1883-2148
• DOI: 10.1002/joa3.12350

Background The cardiopulmonary function is hypothesized to be associated with atrial fibrillation/atrial tachyarrhythmia (AF/AT) recurrence after AF ablation. Purpose To clarify the relationship between the cardiopulmonary function after successful ablation and AF/AT recurrence. Methods We examined 31 patients with paroxysmal AF who underwent AF ablation. Cardiopulmonary exercise testing (CPET) was performed at 1month after the ablation. A continuously increasing loading method on a bicycle ergometer was employed for the CPET. Results No adverse events, including AF/AT recurrence, occurred during the CPET. Among 31 patients, AT/AF recurrence was observed in seven (23%). The ventilatory anaerobic threshold (VAT) and peak oxygen consumption (VO2) were significantly higher in patients without AF/AT recurrence than in those with AT/AF recurrences (peak VO2 23.6 ± 5.7 vs 17.2 ± 4.1 mL/kg/min; VAT, 16.7 ± 2.8 vs 13.8 ± 2.7 mL/min/kg). The areas under the receiver operating characteristic curve for the peak VO2 and VAT were 0.786 (P < .01) and 0.789(P < .01), respectively. Both indices had a sensitivity of 70%–80% and specificity of 70%–80% for predicting AT/AF recurrence. Similar results were obtained for the percent values of the predicted peak VO2 and VAT. Conclusions The present pilot study found that CPET can be performed safely at approximately 1 month after AF ablation. The peak VO2 and VAT were significantly associated with AT/AF recurrence. The peak VO2 and VAT were thought to provide helpful information regarding AT/AF recurrence.