Metabolic syndrome associated with increased risk of recurrence after catheter ablation of atrial fibrillation
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Although metabolic syndrome has been shown to be associated with atrial fibrillation (AF), its impact on the atrial substrate properties and catheter ablation response in AF patients is still unclear. Overall, 282 patients with AF who underwent catheter ablation using a 3-dimensional mapping system were studied, with detailed mapping performed in 59 patients. Patients with metabolic syndrome (NCEP ATP III) exhibited larger atrial sizes, shorter fractionated intervals, and higher dominant frequencies when compared to those without metabolic syndrome. Furthermore, in patients with metabolic syndrome, higher incidences of complex fractionated atrial electrographic sites located in the left atrial appendage base, coronary sinus, and crista terminalis region were found. A higher incidence of recurrent AF was observed in patients with metabolic syndrome. Furthermore, there was a higher incidence of recurrent AF from non-pulmonary vein origins in these patients compared with those without metabolic syndrome. In conclusion, metabolic syndrome appears to be associated with larger left atrial size and more pro-arrhythmogenic substrate, possibly increasing the risk for recurrence after AF ablation.
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