Impact of Catheter Ablation on Mitral Regurgitation and Atrial Fibrillation: A Case Study
DOI:
https://doi.org/10.56294/dm2023340Keywords:
Mitral Regurgitation, Atrial Fibrillation, Mitral Ring, Catheter Ablation, Case StudyAbstract
Mitral regurgitation is recognized as the most common valvulopathy among cardiac valve disorders, with causes divided into primary and secondary components. Traditionally, the secondary component has been associated with the dilation of the ventricular cavity and ring; however, recent interpretations also include the dilation of the left atrium as a significant factor, especially when the dimensions of the left ventricular cavity are preserved. This new perspective has led to a reinterpretation of the pathogenesis, diagnosis, and treatment of atrial functional mitral regurgitation. The research focused on a case study of patients with this condition and atrial fibrillation, who were treated through catheter ablation. This approach was supported by an exhaustive bibliographic review conducted in databases such as MEDLINE via PUBMED. The findings reveal that atrial functional mitral regurgitation, now recognized as a distinct pathological entity, challenges the previous belief that only the dilation of the left ventricle and mitral ring were the causes of the disease. Furthermore, it was determined that catheter ablation is effective not only for restoring sinus rhythm but also for improving valvular function and quality of life in patients with this condition and atrial fibrillation
References
1. Deferm S, Bertrand PB, Verbrugge FH, Verhaert D, Rega F, Thomas JD, et al. Atrial functional mitral regurgitation: JACC review topic of the week. Journal of the American College of Cardiology. 2019;73(19):2465-76. https://www.jacc.org/doi/epdf/10.1016/j.jacc.2019.02.061
2. Grayburn PA, Thomas JD. Basic principles of the echocardiographic evaluation of mitral regurgitation. Cardiovascular Imaging. 2021;14(4):843-53. https://www.jacc.org/doi/epdf/10.1016/j.jcmg.2020.06.049
3. Muraru D, Guta A-C, Ochoa-Jimenez RC, Bartos D, Aruta P, Mihaila S, et al. Functional regurgitation of atrioventricular valves and atrial fibrillation: an elusive pathophysiological link deserving further attention. Journal of the American Society of Echocardiography. 2020;33(1):42-53. https://www.sciencedirect.com/science/article/abs/pii/S0894731719309472
4. García K, Isa R. Ablación de Fibrilación Auricular como tratamiento de primera línea. Revisión de la literatura. Revista chilena de cardiología. 2022;41(2):130-9. https://www.scielo.cl/pdf/rchcardiol/v41n2/0718-8560-rchcardiol-41-02-130.pdf
5. Wesselink R, Vroomen M, Overeinder I, Neefs J, van den Berg NW, Meulendijks ER, et al. El fracaso de la ablación por catéter de la fibrilación auricular se asocia con mayor remodelado y menos eficacia de una posterior ablación toracoscópica. Revista Española de Cardiología. 2023;76(6):417-26. https://www.sciencedirect.com/science/article/pii/S030089322200375X
6. Anguera I, Pérez ÓC, Bazán V. Registro español de ablación con catéter. XXI informe oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2021). Revista Española de Cardiología. 2022;75(12):1029-39. https://www.sciencedirect.com/science/article/pii/S0300893222003372
7. Macías-Ruiz R, Jiménez-Jáimez J, Álvarez-López M, Molina-Lerma M, Sánchez-Millán P, Wangensteen R, et al. Efecto de la ablación con catéter de venas pulmonares en la función renal de pacientes con fibrilación auricular. Estudio de cohortes prospectivo. Revista Española de Cardiología. 2020;73(6):471-8. https://www.sciencedirect.com/science/article/abs/pii/S0300893219304178
8. Doldi P, Stolz L, Orban M, Karam N, Praz F, Kalbacher D, et al. Transcatheter mitral valve repair in patients with atrial functional mitral regurgitation. Cardiovascular Imaging. 2022;15(11):1843-51. https://www.jacc.org/doi/epdf/10.1016/j.jcmg.2022.05.009
9. Kagiyama N, Mondillo S, Yoshida K, Mandoli GE, Cameli M. Subtypes of atrial functional mitral regurgitation: imaging insights into their mechanisms and therapeutic implications. Cardiovascular Imaging. 2020;13(3):820-35. https://www.jacc.org/doi/epdf/10.1016/j.jcmg.2019.01.040
10. Mesi O, Gad MM, Crane AD, Ramchand J, Puri R, Layoun H, et al. Severe atrial functional mitral regurgitation: clinical and echocardiographic characteristics, management and outcomes. Cardiovascular Imaging. 2021;14(4):797-808. https://www.jacc.org/doi/epdf/10.1016/j.jcmg.2021.02.008
11. Cramariuc D, Alfraidi H, Nagata Y, Levine RA, Van Kampen A, Andrews C, et al. Atrial dysfunction in significant atrial functional mitral regurgitation: phenotypes and prognostic implications. Circulation: Cardiovascular Imaging. 2023;16(5):e015089. https://www.ahajournals.org/doi/epub/10.1161/CIRCIMAGING.122.015089
12. Hirji SA, Cote CL, Javadikasgari H, Malarczyk A, McGurk S, Kaneko T. Atrial functional versus ventricular functional mitral regurgitation: prognostic implications. The Journal of Thoracic and Cardiovascular Surgery. 2022;164(6):1808-15. e4. https://www.sciencedirect.com/science/article/abs/pii/S002252232033453X
13. Cotella JI, Pinna C, Prado A. Fibrilación auricular e insuficiencia valvular funcional: otro ejemplo de continuum y autoperpetuación. Revista de la Federación Argentina de Cardiología. 2022;51(3):101-5. https://revistafac.org.ar/ojs/index.php/revistafac/article/view/427
14. Criado JLI, Quesada A, Cózar R, Almendral-Garrote J, Alonso-Fernández P, Alonso-Martín C, et al. Registro Español de Ablación con Catéter. XVIII Informe Oficial de la Sección de Electrofisiología y Arritmias de la Sociedad Española de Cardiología (2018). Revista Española de Cardiología. 2019;72(12):1031-42. https://www.sciencedirect.com/science/article/abs/pii/S0300893219303653
15. Wagner CM, Brescia AA, Watt TM, Bergquist C, Rosenbloom LM, Ceniza NN, et al. Surgical strategy and outcomes for atrial functional mitral regurgitation: All functional mitral regurgitation is not the same! The Journal of Thoracic and Cardiovascular Surgery. 2022;167(2):647-55. https://www.sciencedirect.com/science/article/abs/pii/S0022522322003737
16. Kunstmann S, Gaínza F. Cardiopatía en el paciente anciano. Revista Médica Clínica Las Condes. 2020;31(1):21-7. https://www.sciencedirect.com/science/article/pii/S0716864019301178
Published
Issue
Section
License
Copyright (c) 2023 Aurelia María Cleonares Borbor, Jaime Fernando Armijos Moreta , Amalia Fernanda Vera Veloz (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.
