2/23/2023 0 Comments Refractory atrial flutter icd 10We simultaneously recruited a healthy reference cohort to permit sex-matched comparisons of cardiac chamber remodeling and alterations in contractile health through use of Z-score based analysis. In this study we prospectively recruited a consecutive series of patients clinically referred for pre-procedural CMR prior to first-time PVI. This presents unique opportunities to comprehensively study phenotypic differences between women and men that may contribute to post-PVI AF recurrence. Phenotypic sex differences related to these important discrepancies have not been previously explored.Ĭardiovascular magnetic resonance (CMR) imaging provides accurate and reproducible quantification of the cardiovascular phenotype in patients referred for PVI, inclusive of vascular anatomy and cardiac chamber volumetry ( 20). Among these female patients, higher rates of AF recurrence have been consistently reported vs. Despite contributing to 43% of community reported AF, females currently represent 27% of PVI procedures ( 11). Despite providing value for the improvement of symptom burden and quality of life ( 4, 5), AF recurrence remains common and occurs in up to 43% of patients by 1-year ( 6, 7), this decreasing to 20–35% at 3–5 years following the engagement of repeat interventions ( 8– 10). Pulmonary vein isolation (PVI) is a common invasive therapy for the treatment of symptomatic AF. With rising prevalence over the past two decades ( 2), AF is recognized as an important contributor to cardiovascular hospitalization and healthcare expenditure ( 3). Factors influencing female patient referral for PVI at more advanced stages of atrial disease warrant focused investigation.Ītrial Fibrillation (AF) is the most common arrhythmia encountered in contemporary practice, estimated to affect over 30 million people worldwide ( 1). Assessment of LA contractile health may therefore be of value to identify female patients at elevated risk of AF recurrence. males, the latter independently associated with AF recurrence. Multivariable analysis revealed each of LA minimum and pre-systolic volumes and booster EF Z-scores to be independently associated with AF recurrence, providing respective hazard ratios of 1.10, 1.19, and 0.89 ( p = 0.001, 0.03, and 0.01).Ĭonclusion: Among patients referred for first time PVI, females were older and demonstrated significantly poorer LA contractile health vs. Z-score-based analyses revealed significantly reduced ventricular volumes, greater left atrial (LA) volumes, and reduced LA contractility in females vs. Females were older with higher prevalence of hypertension and thyroid disorders. Results: AF recurrence following first PVI occurred in 41% of males and 59% of females ( p = 0.03). Multivariable analyses adjusting for age and comorbidities were performed to identify independent predictors of AF recurrence. Patients were followed for a median of 2.6 years for the primary outcome of clinical AF recurrence. Multi-chamber volumetric and functional measures were assessed by sex-corrected Z-score analyses vs. Methods: A total of 204 consecutive patients referred for first-time PVI and 101 healthy subjects were prospectively studied by cardiovascular magnetic resonance (CMR) imaging. This prospective cohort study aimed to evaluate the sex-based differences in cardiac phenotype and their influence on (AF) recurrence following first-time PVI. Sex-specific mechanisms underlying this phenomenon are poorly understood. Prior studies have documented elevated AF recurrence rates among females vs. 5Department of Diagnostic Imaging, Cumming School of Medicine, University of Calgary, Calgary, AB, Canadaīackground: Pulmonary vein isolation (PVI) is a commonly engaged therapy for symptomatic atrial fibrillation (AF).4Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.3Department of Cardiovascular Medicine, Cairo University, Cairo, Egypt.2Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.1Stephenson Cardiac Imaging Centre, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada.Alena Yakimenka 1,2, Dina Labib 1,3, Steven Dykstra 1, Yoko Mikami 1, Alessandro Satriano 1, Jacqueline Flewitt 1, Patricia Feuchter 1, Sandra Rivest 1, Andrew G.
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