Search

Background RE-CIRCUIT (NCT02348723) and ABRIDGE-J (UMIN000013129) are recently published randomized clinical trials showing that anticoagulation therapy with dabigatran during the periprocedural period of catheter ablation (CA) for atrial fibrillation (AF) was associated with fewer complications. However, the dabigatran administration protocols were different (uninterrupted in RE-CIRCUIT and minimally interrupted in ABRIDGE-J). The aim of this present study was to clarify the optimal interruption time of dabigatran Oral administration to Ablation (O-A time). Methods We conducted an integrated analysis of the 2 prospective trials. The endpoint of the study was the incidence of major bleeding events during and up to 8 weeks after CA across participants with different O-A times. Results The 535 patients in the dabigatran groups of the 2 trials were divided into 3 groups based on their O-A times ( 24 h, n = 86). Major bleeding events occurred in 5 patients (1.9%) in the 24 h group; however, no major bleeding events occurred in the 8–24 h group (3 group-comparison, p = 0.026). No thromboembolic complication was observed in any of the 3 O-A time groups. Conclusion In patients undergoing CA for AF using dabigatran as a periprocedural anticoagulant, an O-A time of 8–24 h was associated with no bleeding complications. These data suggest that an O-A time of 8–24 h may be an appropriate option, especially in a low thromboembolic-risk patient.

Purpose: Several clinical models and scales have been reported to predict prognosis of patients who have hospitalized due to acute decompensated heart failure (ADHF). It is known that high blood urea nitrogen (BUN) levels and low activities of daily living are associated with a worse prognosis in patients with HF. Barthel Index (BI) is an ordinal scale used to measure performance in activities of daily living and functional independence in the domains of personal care and mobility. The aim of this study was to investigate the association between BI/BUN ratio and the incidence of clinical outcomes in patients with ADHF. Methods: A cohort of 76 patients admitted to our institution from August 2019 to December 2019 due to ADHF was enrolled. We investigated the characteristics of these patients and BI at their discharge. Clinical outcome was major adverse cardiovascular event (MACE) which include cardiovascular death and re-hospitalization for worsening HF. We performed ROC analysis for MACE. Results: The patients had a mean age of 78.0 years and 61.8% were male. Incidence of MACE was 51.3% in entire patients. We explored the association between BI/BUN ratio and post-discharge MACE. Area under the curve of BI/BUN ratio for MACE was 0.66(95% CI: 0.54-0.78) and the cut off value was 2.01 (specificity 0.784, sensitivity 0.538). We divided patients into 2 groups according to cut off value; high BI/BUN (>2: n=48) and low BI/BUN ( Conclusion: We suggest that low BI/BUN ratio predicts poor prognosis in patients admitted due to ADHF.

Background Although regular physical activity has beneficial cardiovascular effects, exercise can trigger sudden cardiac arrest (SCA). Coronary artery disease (CAD) was identified as the most common cause of an exercise-related out-of-hospital cardiac arrest (OHCA). Regular exercise has been reported to reduce the risk of plaque rupture in animal studies and basic research. Therefore, we compared the coronary artery findings in CAD-OHCA patients with and without habitual exercise. There have been few reports on whether regular exercise changes the prognosis in OHCA due to CAD (CAD-OHCA). We investigated the association between the better clinical outcome and the regular exercise in patients with CAD-OHCA. Methods This is a single-center retrospective analysis from 2006 to 2019. The consecutive 397 patients with OHCA due to myocardial ischemia underwent coronary angiography (CAG). After excluding 73 patients with vasospastic angina, the remaining 324 patients with CAD were enrolled in this study. We divided these patients into two groups according to whether they were habitually exercising (Exercise group: N=37) or not/unknown (Non-Exercise group: N=287). Clinical outcome was a 30-day survival with minimal neurologic impairment represented by a Glasgow-Pittsburgh Cerebral Performance Categories Scale value 1 or 2. Results The patients in the Exercise Group were significantly younger (exercise vs. non-exercise, 57±12 vs. 64±12 years; P Conclusions The patients with habitual exercise had less plaque rupture, less coronary thrombosis than non-exercise. The patients with regular exercise had better clinical outcomes than non-exercise after CAD-OHCA. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Tokyo Metropolitan Goverment Figure 1. Findings of the culprit lesion in coronar arteriesFigure 2. Kaplan-Meier analysis

Patient: Female, 71-year-old Final Diagnosis: Pacemaker related pleural effusion Symptoms: Dry cough Medication:— Clinical Procedure: — Specialty: Cardiology • General and Internal Medicine Objective: Unusual or unexpected effect of treatment Background: Post-cardiac injury syndrome, including pleural effusion as a delayed complication of permanent pacemaker implantation, has rarely been reported. To resolve pleural effusion, prolonged chest tube placement is often required. Anti-inflammatory agents combined with diuretics are also often prescribed. Saireito, a Japanese herbal medication, which is a combination of Goreisan and Shousaikoto, has both anti-inflammatory and water-modulation properties and has been used for edema (lymph edema, cerebral edema) and inflammation (chronic nephritis). Case Report: We describe a 71-year-old woman with a history of syncope and bradycardia who underwent dual permanent pacemaker implantation (placed in the right chest because of a persistent left superior vena cava) without complications. Two months later, she came to the hospital as an outpatient with a dry cough, and was diagnosed with right-sided pleural effusion. A pleural fluid analysis revealed exudative effusion, according to Light’s criteria. The fluid was negative for infectious etiology. Chest X-ray, computed tomography, and echocardiography revealed no signs of pericardial effusion or perforation of the pacemaker lead to outside the heart. The pleural effusion persisted despite use of anti-inflammatory medication for several weeks and diuretics for a short period. Saireito was administered with good response; the pleural effusion resolved completely and there was no deterioration of renal function. Conclusions: The present case highlights the clinical significance of Saireito as an effective therapeutic agent for late-onset pacemaker-related pleural effusion, without adverse effects such as renal dysfunction.

Issues concerning Black Companies have been extensively discussed in Japan recently. This paper aims to understand how discourses on Black Companies have been constructed and altered within the Japanese social context. To achieve this, we conducted discourse analysis using the case of Dentsu Inc., focusing especially on the multi-levels of discourse and power relations. We find that the process of power emergence in Black Companies and of values relating to the ethic of hard work on the part of employees relate to three levels of discourse: micro-discourse, meso-discourse and macro-discourse. This paper contributes to discourse studies by establishing that one discourse emerges under the influence of other discourses. As a practical contribution, this finding will assist those struggling with injustices in their organisation by enabling them to change their difficult situations via involvement with various discourses.

Background Catheter ablation of LV summit VT can be challenging due to possible subepicardial or intramural site of origin and its close proximity to the major coronary vessels. Objective Local electrograms monitoring inside LV summit communicating vein potentially defines arrhythmogenic substrates and facilitates ablation from the adjacent anatomical structures. Results We experienced two cases of LV summit VT with epicardial local abnormal ventricular activities (Epi-LAVA) recorded from distal bipolar electrode of the 2F microcatheter in communicating vein close to the superior portion of LV summit. During sinus rhythm, Epi-LAVA displayed isolated late fractionated potentials in the first case but had initial fractionated potentials fused with terminal portion of far-field ventricular signals and late isolated potentials exhibiting 2:1 conduction in the second case. Epi-LAVA represented earliest ventricular signals during VT in both cases. Pace mapping at Epi-LAVA sites yielded single QRS morphology with excellent pacemap score and induced VT. Our strategy was to perform ablation at the facing site of Epi-LAVA aiming to eliminate the potentials transmurally. Radiofrequency (RF) energy was applied above and under the left coronary cusp opposite to Epi-LAVA sites using 3.5-mm tip open-irrigation catheter with a power of 30–35 W for 60 seconds under real-time intracardiac echocardiograhic guidance. VT was slowed and terminated in 1 second. Repeat ablation delayed and completely abolished Epi-LAVA followed by noninducibility of VT. Anatomical proximity of the left coronary cusp semilunar insertion and subepicardial or intramural site of origin possibly dictates successful ablation. Epi-LAVA from coronary vein mapping serve as a new landmark of the ablation target with a measurable procedural endpoint. Conclusion Elimination of epicardial substrates with RF energy application at the left coronary cusp can be a novel strategy for LV summit VT ablation. Funding Acknowledgement Type of funding source: None

Background and objectives: Pulmonary vein (PV) reconnection is a major reason for recurrence after catheter ablation of paroxysmal atrial fibrillation (PAF). However, the timing of the recurrence varies between patients, and recurrence &gt, 1 year after ablation is not uncommon. We sought to elucidate the characteristics of atrial fibrillation (AF) that recurred in different follow-up periods. Materials and Methods: Study subjects comprised 151 consecutive patients undergoing initial catheter ablation of PAF. Left atrial volume index (LAVi) and atrial/brain natriuretic peptide (ANP/BNP) levels were systematically measured annually over 3 years until AF recurred. Results: Study subjects were classified into four groups: non-recurrence group (n = 84), and short-term- (within 1 year) (n = 30), mid-term- (1&ndash, 3 years) (n = 26), and long-term-recurrence group (&gt, 3 years) (n = 11). The short-term-recurrence group was characterized by a higher prevalence of diabetes mellitus (hazard ratio 2.639 (95% confidence interval, 1.174&ndash, 5.932), p = 0.019 by the Cox method), frequent AF episodes (&ge, 1/week) before ablation (4.038 (1.545&ndash, 10.557), p = 0.004), and higher BNP level at baseline (per 10 pg/mL) (1.054 (1.029&ndash, 1.081), p &lt, 0.0001). The mid-term-recurrence group was associated with higher BNP level (1.163 (1.070&ndash, 1.265), p = 0.0004), larger LAVi (mL/m2) (1.033 (1.007&ndash, 1.060), p = 0.013), and longer AF cycle length at baseline (per 10 ms) (1.194 (1.058&ndash, 1.348), p = 0.004). In the long-term-recurrence group, the ANP and BNP levels were low throughout follow-up, as with those in the non-recurrence group, and AF cycle length was shorter (0.694 (0.522&ndash, 0.924), p = 0.012) than those in the other recurrence groups. Conclusions: Distinct characteristics of AF were found according to the time to first recurrence after PAF ablation. The presence of secondary factors beyond PV reconnections could be considered as mechanisms for the recurrence of PAF in each follow-up period.

Antral pulmonary vein isolation (PVI) using a radiofrequency hot balloon catheter (RHB) is a feasible therapeutic option for treating atrial fibrillation (AF). Lesion durability after antral RHB-PVI remains unknown. This study aimed to evaluate lesion durability and the associations between procedural characteristics after antral RHB-PVI. A total of 200 patients received antral RHB-PVI using the single-shot technique between April 2016 and March 2018. Antral RHB-PVI was performed following a pre-specified protocol and RHB energy application was performed for a maximum of two times for each PV. Consecutive patients who underwent repeated procedures for recurrence of any type of atrial tachyarrhythmia were enrolled. Twenty-six (13%) patients underwent repeated ablation and 20 patient documented AF recurrence (AF group) and 6 patients documented non-AF recurrence (non-AF group). Repeated ablation was performed at a median (25th, 75th percentiles) of 378 days (217, 487) after the initial procedure and durable PVI was observed in 86 (83.5%) PVs. Durability reached 89.7% when PVI was achieved only using an RHB. In the AF group (79 PVs), durable PVI was observed in 62 (78.5%) PVs, whereas all 24 PVs were still isolated in the non-AF group. The majority of reconnection sites were around the superior PVs. Antral RHB-PVI shows high lesion durability, especially with both inferior PVs.

Despite the use of steroid-eluting leads, a transient but not persistent rise in the atrial/ventricular capture threshold (TRACT/TRVCT) can occur early after pacemaker implantation in patients with sick sinus syndrome. This study aimed to assess the prevalence, predictors, and mechanisms of TRACT/TRVCT in patients with heart failure undergoing implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy (CRT) implantation. One hundred twenty consecutive patients underwent ICD (N = 70) or CRT (N = 50) implantation. Capture threshold was measured at implantation, 7-day, 1-month, and 6-month post-implantation. TRACT/TRVCT was defined as a threshold rise at 7 days by more than twice the height of the threshold at implantation, with full recovery during follow-up. Atrial and brain natriuretic peptide (ANP and BNP) levels were measured before implantation. TRACT and TRVCT were observed in 13 (11%) and 10 (8%) patients, respectively. Patients with TRACT had lower ANP level (median 72 [42–105] vs. 99 [49–198] pg/mL, P = 0.06), lower ANP/BNP ratio (0.29 [0.20–0.36] vs. 0.50 [0.33–0.70], P

Introduction The superior vena cava (SVC) is a main source of non-pulmonary vein (PV) ectopies initiating atrial fibrillation (AF). Empiric SVC isolation may improve rhythm outcomes after catheter ablation of AF. Because the SVC passes immediately adjacent to the right superior PV (RSPV), an electrophysiological relation could be present between the two structures. The present study aimed to estimate the interrelation between the SVC and RSPV by evaluating arrhythmogenic activities observed during catheter ablation of AF. Methods and results Study subjects comprised 121 consecutive patients referred for catheter ablation of paroxysmal AF. Isoproterenol infusion was used to induce ectopies and AF. Patients were divided into two groups depending on the presence of arrhythmogenic SVC: arrhythmogenic-SVC (A-SVC) and non-arrhythmogenic SVC (Non-A-SVC) groups. The prevalence of females was higher and body surface area was smaller in the A-SVC group (N = 22) than Non-A-SVC group (N = 99). Arrhythmogenic activities were observed in 60 (49%) RSPVs, 24 (20%) right inferior PVs, 72 (59%) left superior PVs, and 31 (25%) left inferior PVs. Arrhythmogenic RSPVs were more prevalent in the A-SVC group than Non-A-SVC group (86% vs 41%, P = 0.0001), whereas these prevalences in the other 3 PVs were not different between groups (P>0.3). In multivariable analysis, arrhythmogenic RSPV was the only independent predictor of arrhythmogenicity of the SVC (OR, 8.53; 95% CI 2.31–31.46; P = 0.001). Conclusions An electrophysiological interrelation may be present between the SVC and RSPV in patients with paroxysmal AF. Semi-empiric SVC isolation limited to patients with an arrhythmogenic RSPV may be a more efficient treatment strategy. This article is protected by copyright. All rights reserved

The present study discusses modern managerial means and nature through telework, which has been viewed favourably for not only increasing white-collar productivity but also for improving work/life balance. In existing studies, the effect on society has been at the forefront of discussions while investigations about introductory methods or the actual conditions of telework are also active. However, there are few studies on conceptualization and the essential significance. For these reasons, this study will exactingly define the classifications and examine whether telework is a modern labour form in the context of “space-time” and “trust” and clarify the functions of organizational communication and leadership. Finally, we will present a research framework for further studies to comprehend the transformation of managerial nature from traditional work to modern telework through interviews with two Japanese information and communications technology companies.

Background Successful bipolar radiofrequency catheter ablation (RFCA) of refractory ventricular arrhythmias (VAs) has been reported. However, the efficacy, safety, and long-term outcomes of bipolar RFCA of VAs are not fully determined. Objective The purpose of this study was to evaluate the effectiveness and safety of bipolar RFCA in treating refractory VAs during long-term follow-up. Methods Eighteen patients who underwent bipolar RFCA for ventricular tachycardia (VT) at 7 institutions were retrospectively investigated. Underlying heart diseases included remote myocardial infarction (n = 3 [17%]) and nonischemic cardiomyopathy (n = 15 [83%]). Although unipolar RFCA was performed in all patients, either it failed to suppress VT or VT recurred. The interventricular septum, left ventricular free wall, and left ventricular summit were targeted for bipolar RFCA. Results Acute success (VT termination and/or noninducibility) was achieved with bipolar RFCA in 16 patients (89%). Complications during the procedure included complete atrioventricular block (n = 2) and coronary artery stenosis (n = 1). One patient underwent chemical ablation after bipolar RFCA failure. At 12-month follow-up, VT reoccurred in 8 patients (44%). However, in patients with recurrence, VT burden had decreased: only 4 patients underwent re-RFCA, and only 1 of the 4 required chemical ablation. In the remaining 4 patients, re-RFCA was not required, as VT was controlled by medication or an implantable cardioverter-defibrillator. Conclusion Bipolar RFCA is useful for acute suppression of refractory VT. Although VT recurrence rates during long-term follow-up were relatively high, we observed a significant reduction in VT burden.

It has been designated that humans have lost the balance between nature and society, and firms are expected to proactively contribute to a circular economy that minimizes harm to the world. To respond to these issues, this paper investigates the way of balancing environmental protection with corporate profits based on the Porter hypothesis, which is a well-known view on management practice. The hypothesis has been tested in many recent empirical studies, being supported until now; however, studies hardly used the organization theory approach effectively and they are restricted as the technological aspect of society was not treated. Therefore, we incorporate the co-evolutionary dual couplings model and clarify the interaction between the organizational and societal levels. Regarding the former, this study examines the interactions among four variables: environmental protection culture (containing technology), organizational capability, environmental performance, and economic performance, by multivariate analysis with the data of 498 Japanese firms. Regarding the latter, the study proposes a technological shift by employing the concept of the planned obsolescence-driven circular economy.

Patient: Female, 54-year-old Final Diagnosis: Takotsubo cardiomyopathy Symptoms: Chest discomfort • general malaise Medication: — Clinical Procedure: — Specialty: Cardiology Objective: Unusual clinical course Background: Takotsubo cardiomyopathy is characterized by apical ballooning and excessive constriction of the base of heart. However, reverse takotsubo cardiomyopathy, wherein ballooning from the mid-ventricle to the base of the heart occurs with excessive constriction of the apex, has also been reported. We report a case of a transition from atypical wall motion abnormality to a typical takotsubo cardiomyopathy pattern. Case Report: A 54-year-old woman was following excessive sugar and dietary restrictions because of concerns regarding her blood sugar levels while receiving treatment for diabetes at another hospital. She presented at our hospital with general malaise and chest discomfort after several days of significantly increased workload. On admission, blood tests showed elevated cardiac enzymes. Electrocardiogram showed ST elevation of V2-V3 and poor R-wave enhancement of the anterior precordial lead. Coronary angiography showed no significant stenosis; however, left ventricular (LV) angiography showed a decrease in mid-ventricular wall motion. On the basis of these findings, she was diagnosed with a reverse takotsubo cardiomyopathy. We initiated conservative treatment for her condition. During her treatment, the LV wall motion showed a typical pattern of the apical ballooning that is characteristic of takotsubo cardiomyopathy. This LV wall motion was normalized on day 22 of the onset. Conclusions: We observed a rare case of takotsubo cardiomyopathy where the pattern of LV wall motion abnormality changed over time. This case suggests that it is necessary to follow up LV abnormality over time rather than rely on single-point observations in cases with takotsubo cardiomyopathy.

Introduction Dominant frequency (DF) derived from fast Fourier transform (FFT) analysis has failed to guide atrial fibrillation (AF) ablation since it cannot guarantee temporal stability. Continuous wavelet transform (CWT) analysis is another frequency analysis that can show the temporal stability of a frequency. Methods and results Forty-four consecutive patients with persistent AF (PeAF) underwent pulmonary vein (PV) isolation (PVI) as the first-time catheter ablation. The PVs and left atrium were mapped and electrograms (EGMs) were recorded for 30 seconds at each site. Pseudo-frequency (PF) and coefficient of variation (CV) were calculated by CWT analysis. A PF with CV ≤ 10 was defined as a temporally stable PF (sPF). DF was also calculated by traditional FFT analysis from the first 5 seconds of the recorded EGMs. The highest sPF was shown inside the PVs in 20 patients (PV group), and at the non-PV sites in 24 patients (non-PV group). During the follow-up period of 15.3 ± 4.4 months, the ablation success rate in the PV group was significantly higher than that in the non-PV group (90% vs. 62%, P = 0.023). The location of the highest DF did not have a significant effect on ablation success rate between inside the PVs and at the non-PV sites. Conclusion PVI results for PeAF were significantly worse for patients with highest sPF at the non-PV sites compared to patients with highest sPF sites inside the PVs. CWT analysis during AF could be used to verify whether PVI alone is sufficient for the first-time catheter ablation in patients with PeAF.

This study is founded on contingency theory, which is derived from organization theory, and in it we examine the structural problems of the modern Japanese recycling business using J. D. Thompson's model of contingency theory. Based on the results of our interviews conducted with 16 companies through the nondirective method, we argue that there are multiple contingency factors in the modern Japanese recycling venture and that these factors increase uncertainty and reduce the stability of the business as a result. We conclude that as an active level of 'sub technology,' recycling businesses created as diversifications of major companies will eventually manage the multiplicity of contingency factors.

Plasma norepinephrine (NE) level can be a guide to mortality in patients with heart failure. This study aimed to evaluate the significance of plasma NE level compared with plasma natriuretic peptides (atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP)) levels in patients with atrial fibrillation (AF).Included in this study were 137 consecutive patients referred for catheter ablation of lone AF (paroxysmal in 90 and persistent in 47 patients). Blood samples for measurements of ANP, BNP and NE were drawn in the supine position before the procedure.ANP, BNP and NE levels were greater in patients with persistent AF than in patients with paroxysmal AF (median (25th-75th centile)=28 (18-49) vs 69 (36-106), p0.0001; 28 (15-50) vs 94 (39-156), p0.0001; and 315 (223-502) vs 382 (299-517) pg/mL, p=0.04, respectively). NE level correlated weakly with ANP and BNP levels (r=0.28 and r=0.23, respectively, p0.01 for both). BNP and NE levels differed between patients with and without recurrence of AF (55 (26-135) vs 35 (18-64), p=0.005 and 431 (323-560) vs 302 (225-436) pg/mL, p0.001, respectively). Of note, only NE level was significantly greater in patients with symptomatic sick sinus syndrome (SSS) (n=21) than in those without SSS (560 (466-632) vs 321 (242-437) pg/mL, p0.0001). Logistic regression analysis showed NE level to be the only independent discriminator for SSS (OR 1.006, 95% CI 1.002 to 1.010, p=0.001).An increase in plasma NE level was observed in patients with AF and SSS. Although this implies a pathophysiological link between clinical manifestation of SSS and the autonomic nervous dysfunction, further studies are needed to clarify the mechanisms for this novel finding.

Catheter ablation of atrial fibrillation (AF) is considered to be better than anti-arrhythmic drug therapy in terms of maintaining sinus rhythm, and therefore, it has rapidly evolved to become a commonly performed procedure in major hospitals throughout the world. However, on the basis of the evidence currently available, we support the current guidelines recommending antiarrhythmic drugs as a first-line treatment in most patients with AF except younger patients with symptomatic paroxysmal AF with no evidence of structural heart disease, given the risk of fatal complications associated with the ablation procedure. We would like to emphasize that center volume and individual procedure experience are significant determinants of procedure-related complications. As another effect of AF ablation, preventing atrial remodeling and progression to persistent AF is also noteworthy. Further long-term data is needed to answer the question of whether ablation can prevent or delay the advance of structural remodeling and improve life prognosis, particularly in younger patients.

Although radiofrequency ablation energy creates localized lesions and myocardial necrosis leading to troponin T (TnT) release into the systemic circulation, the significance of TnT elevation post atrial fibrillation (AF) ablation is unknown. We aimed to demonstrate a possible mechanism of left

Although radiofrequency ablation creates myocardial necrosis leading to troponin T (TnT) release into the systemic circulation, the significance of TnT elevation after atrial fibrillation (AF) ablation is unknown.To demonstrate a possible mechanism of reverse structural remodeling in the left atrium (LA) by evaluating postprocedural TnT elevation.This study included 106 patients with an enlarged LA (paroxysmal AF, n = 43; persistent AF, n = 63). All patients underwent pulmonary vein isolation alone in the index procedure. Left atrial volume indexed to body surface area (LAVi) was measured by echocardiography before ablation and 6 months after sinus rhythm restoration. Patients were divided into responders (n = 53) and nonresponders (n = 53) based on a cutoff value of 23% reduction in LAVi. The TnT level was measured 12 hours postprocedure.LAVi decreased from 43 ± 13 to 33 ± 12 mL/m(2) (P.0001). The TnT level was higher in responders than in nonresponders (1.31 ± 0.34 μg/L vs 0.88 ± 0.29 μg/L; P.0001) and correlated linearly with percent reduction in LAVi (R = .54; P.0001). Also in multivariate analysis, the TnT level was the only independent predictor for responders (odds ratio 90.1; 95% confidence interval 14.95-543.3; P.0001). The TnT level in patients who required a repeat procedure (n = 30) was lower than that in patients who did not require a repeat procedure only in the persistent AF group (0.92 ± 0.38 μg/L vs 1.16 ± 0.37 μg/L; P = .01).Greater elevation of the TnT level was related both to favorable outcomes after ablation and to greater reversal of structural remodeling. Postprocedural TnT level may be reflective of the preservation of healthy LA myocardium.