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

Abstract

Abstract 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.

Keywords

• cardiopulmonary function
• exercise
• irrigated catheter
• outcome
• percutaneous catheter treatment
• radiofrequency energy