Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Original Article

Volume 15, Number 4, August 2024, pages 298-308

Does Sinus Rhythm Restoration in Patients With Atrial Fibrillation Undergoing Pulmonary Vein Isolation Have Acute Hemodynamic Benefits?

Figure 1. Changes in heart rate and blood pressure from before to 19 ± 16 min after sinus rhythm restoration in the pre-atrial fibrillation group (a) and from before to after pulmonary vein isolation in the control group (b). AF: atrial fibrillation; bpm: beats per minute; DBP: diastolic blood pressure; HR: heart rate; LAP: left atrial pressure; MAP: mean arterial pressure; SBP: systolic blood pressure.

Figure 2. Comparison of the changes in heart rate and blood pressure from before to after pulmonary vein isolation in the pre-atrial fibrillation and control groups. AF: atrial fibrillation; bpm: beats per minute; ΔDBP: change in diastolic blood pressure; ΔHR: change in heart rate; ΔLAP: change in left atrial pressure; ΔMAP: change in mean arterial pressure; ΔSBP: change in systolic blood pressure.

Figure 3. Comparison of changes in heart rate and blood pressure from before to after pulmonary vein isolation in patients with paroxysmal, persistent, and long-standing persistent atrial fibrillation. bpm: beats per minute; ΔDBP: change in diastolic blood pressure; ΔHR: change in heart rate; ΔLAP: change in left atrial pressure; LSPAF: long-standing persistent atrial fibrillation; ΔMAP: change in mean arterial pressure; PAF: paroxysmal atrial fibrillation; PerAF: persistent atrial fibrillation; ΔSBP: change in systolic blood pressure.

Figure 4. Comparison of the changes in heart rate and blood pressure from before to after pulmonary vein isolation in patients with the quartiles of atrial fibrillation-heart rate. bpm: beats per minute; ΔDBP: change in diastolic blood pressure; ΔHR: change in heart rate; ΔLAP: change in left atrial pressure; ΔMAP: change in mean arterial pressure; Q: quartile; ΔSBP: change in systolic blood pressure.

Figure 5. Comparison of the changes in heart rate and blood pressure from before to after pulmonary vein isolation in patients with the quartiles of left atrial dimension. bpm: beats per minute; ΔDBP: change in diastolic blood pressure; ΔHR: change in heart rate; ΔLAP: change in left atrial pressure; ΔMAP: change in mean arterial pressure; Q: quartile; ΔSBP: change in systolic blood pressure.

**Table 1.** Clinical Characteristics in the Pre-AF and Control Groups
	Pre-AF group (n = 74)	Control group (n = 71)	Pre-AF vs. control P value
AADs: anti-arrhythmic drugs; ACEI: angiotensin-converting enzyme inhibitors; AF: atrial fibrillation; ARB: angiotensin receptor blocker; ARNI: angiotensin receptor neprilysin inhibitor; BMI: body mass index; BNP: brain natriuretic peptide; CCr: creatinine clearance; CTI: cavotricuspid isthmus; DM: diabetes mellitus; Hb: hemoglobin; HTN: hypertension; LAD: left atrial dimension; LSPAF: long-standing persistent atrial fibrillation; LVDd: left ventricular end-diastolic dimension; LVDs: left ventricular end-systolic dimension; LVEF: left ventricular ejection fraction; LVWT: left ventricular wall thickness; MRA: mineralocorticoid receptor antagonist; NYHA: New York Heart Association; PAF: paroxysmal atrial fibrillation; PerAF: persistent atrial fibrillation; SGLT2i: sodium-glucose cotransporter-2 inhibitor.
Age, years	66 ± 8	67 ± 10	0.44
Male, n (%)	55 (74)	47 (66)	0.28
AF classification
PAF, n (%)	5 (7)	71 (100)	< 0.001
PerAF, n (%)	48 (65)	0 (0)	< 0.001
LSPAF, n (%)	21 (28)	0 (0)	< 0.001
BMI, kg/m²	24.5 ± 3.6	23.3 ± 3.1	0.035
Comorbidities
HTN, n (%)	45 (61)	44 (62)	0.88
DM, n (%)	12 (16)	6 (9)	0.15
Vascular disease, n (%)	23 (31)	21 (30)	0.84
Stroke, n (%)	8 (11)	5 (7)	0.42
NYHA functional class
I, n (%)	37 (50)	62 (87)	< 0.001
II, n (%)	37 (50)	9 (13)	< 0.001
Laboratory test
Hb, g/dL	14.4 ± 1.3	13.5 ± 1.6	< 0.001
CCr, mL/min	76.8 ± 23.6	75.5 ± 23.6	0.74
BNP, pg/mL	179.1 ± 71.8	58.0 ± 47.6	< 0.001
Echocardiographic parameters
LAD, mm	44.0 ± 5.6	39.5 ± 6.4	< 0.001
LVDd, mm	46.4 ± 5.8	45.8 ± 4.8	0.46
LVDs, mm	31.4 ± 6.2	29.4 ± 6.4	0.059
LVEF, %	59.3 ± 9.6	64.6 ± 9.2	0.001
LVWT, mm	9.7 ± 1.4	9.4 ± 1.8	0.27
Medications
Heart failure drugs
ACEI/ARB, n (%)	27 (37)	32 (45)	0.29
ARNI, n (%)	4 (5)	2 (3)	0.43
MRA, n (%)	9 (12)	9 (13)	0.93
SGLT2i, n (%)	7 (10)	5 (7)	0.6
Loop diuretics, n (%)	18 (24)	12 (13)	0.27
AADs
Class I AADs, n (%)	5 (7)	9 (13)	0.22
Amiodarone, n (%)	1 (1)	4 (6)	0.15
Bepridil, n (%)	16 (22)	28 (39)	0.019
β-blockers, n (%)	49 (66)	42 (59)	0.37
Others, n (%)	6 (8)	3 (4)	0.33
Redo AF ablation, n (%)	13 (18)	13 (18)	0.9
CTI ablation, n (%)	3 (4)	24 (34)	< 0.001

Table 1. Clinical Characteristics in the Pre-AF and Control Groups

Pre-AF group (n = 74)

Control group (n = 71)

Pre-AF vs. control P value

AADs: anti-arrhythmic drugs; ACEI: angiotensin-converting enzyme inhibitors; AF: atrial fibrillation; ARB: angiotensin receptor blocker; ARNI: angiotensin receptor neprilysin inhibitor; BMI: body mass index; BNP: brain natriuretic peptide; CCr: creatinine clearance; CTI: cavotricuspid isthmus; DM: diabetes mellitus; Hb: hemoglobin; HTN: hypertension; LAD: left atrial dimension; LSPAF: long-standing persistent atrial fibrillation; LVDd: left ventricular end-diastolic dimension; LVDs: left ventricular end-systolic dimension; LVEF: left ventricular ejection fraction; LVWT: left ventricular wall thickness; MRA: mineralocorticoid receptor antagonist; NYHA: New York Heart Association; PAF: paroxysmal atrial fibrillation; PerAF: persistent atrial fibrillation; SGLT2i: sodium-glucose cotransporter-2 inhibitor.

Age, years

66 ± 8

67 ± 10

0.44

Male, n (%)

55 (74)

47 (66)

0.28

AF classification

PAF, n (%)

5 (7)

71 (100)

< 0.001

PerAF, n (%)

48 (65)

0 (0)

< 0.001

LSPAF, n (%)

21 (28)

0 (0)

< 0.001

BMI, kg/m²

24.5 ± 3.6

23.3 ± 3.1

0.035

Comorbidities

HTN, n (%)

45 (61)

44 (62)

0.88

DM, n (%)

12 (16)

6 (9)

0.15

Vascular disease, n (%)

23 (31)

21 (30)

0.84

Stroke, n (%)

8 (11)

5 (7)

0.42

NYHA functional class

I, n (%)

37 (50)

62 (87)

< 0.001

II, n (%)

37 (50)

9 (13)

< 0.001

Laboratory test

Hb, g/dL

14.4 ± 1.3

13.5 ± 1.6

< 0.001

CCr, mL/min

76.8 ± 23.6

75.5 ± 23.6

0.74

BNP, pg/mL

179.1 ± 71.8

58.0 ± 47.6

< 0.001

Echocardiographic parameters

LAD, mm

44.0 ± 5.6

39.5 ± 6.4

< 0.001

LVDd, mm

46.4 ± 5.8

45.8 ± 4.8

0.46

LVDs, mm

31.4 ± 6.2

29.4 ± 6.4

0.059

LVEF, %

59.3 ± 9.6

64.6 ± 9.2

0.001

LVWT, mm

9.7 ± 1.4

9.4 ± 1.8

0.27

Medications

Heart failure drugs

ACEI/ARB, n (%)

27 (37)

32 (45)

0.29

ARNI, n (%)

4 (5)

2 (3)

0.43

MRA, n (%)

9 (12)

9 (13)

0.93

SGLT2i, n (%)

7 (10)

5 (7)

0.6

Loop diuretics, n (%)

18 (24)

12 (13)

0.27

AADs

Class I AADs, n (%)

5 (7)

9 (13)

0.22

Amiodarone, n (%)

1 (1)

4 (6)

0.15

Bepridil, n (%)

16 (22)

28 (39)

0.019

β-blockers, n (%)

49 (66)

42 (59)

0.37

Others, n (%)

6 (8)

3 (4)

0.33

Redo AF ablation, n (%)

13 (18)

0.9

CTI ablation, n (%)

3 (4)

24 (34)

< 0.001

**Table 2.** Comparison of Intraprocedural Parameters Between the Pre-AF and Control Groups
	Pre-AF group (n = 74)	Control group (n = 71)	Pre-AF vs. control P value
AF: atrial fibrillation; DBP: diastolic blood pressure; HR: heart rate; LAP: left atrial pressure; MAP: mean arterial pressure; N/A: not applicable; SBP: systolic blood pressure; SR: sinus rhythm.
Pre-measurement
HR_pre, bpm	82.5 ± 20.2	59.7 ± 9.9	< 0.001
SBP_pre, mm Hg	100.8 ± 21.5	108.5 ± 20.7	0.029
DBP_pre, mm Hg	64.4 ± 12.9	56.5 ± 12.5	< 0.001
MAP_pre, mm Hg	78.7 ± 15.8	76.5 ± 16.3	0.39
LAP_pre, mm Hg	7.9 ± 4.4	5.3 ± 3.3	< 0.001
Intraprocedural comparison
Total infusion, mL	1,120.6 ± 420.2	999.7 ± 379.6	0.071
Sedatives
Dexmedetomidine, µg	73.8 ± 25.2	74.8 ± 37.2	0.84
Fentanyl, mg	0.16 ± 0.05	0.17 ± 0.06	0.26
Diazepam, mg	8.4 ± 3.5	9.1 ± 4.5	0.32
Thiopental, mg	90.1 ± 41.8	N/A	N/A
Contrast agent, mL	28.1 ± 11.6	28.2 ± 9.9	0.96
The time after SR restoration, min	18.5 ± 15.5	N/A	N/A
Procedure time, min	168.3 ± 46.4	159.5 ± 52.3	0.29
Post-measurement
HR_post, bpm	66.2 ± 10.7	65.6 ± 10.9	0.71
SBP_post, mm Hg	110.7 ± 26.0	120.6 ± 24.5	0.019
DBP_post, mm Hg	65.7 ± 15.0	65.3 ± 13.0	0.86
MAP_post, mm Hg	83.7 ± 19.4	87.4 ± 16.7	0.21
LAP_post, mm Hg	12.1 ± 4.0	8.8 ± 3.9	< 0.001

Table 2. Comparison of Intraprocedural Parameters Between the Pre-AF and Control Groups

Pre-AF group (n = 74)

Control group (n = 71)

Pre-AF vs. control P value

AF: atrial fibrillation; DBP: diastolic blood pressure; HR: heart rate; LAP: left atrial pressure; MAP: mean arterial pressure; N/A: not applicable; SBP: systolic blood pressure; SR: sinus rhythm.

Pre-measurement

HR_pre, bpm

82.5 ± 20.2

59.7 ± 9.9

< 0.001

SBP_pre, mm Hg

100.8 ± 21.5

108.5 ± 20.7

0.029

DBP_pre, mm Hg

64.4 ± 12.9

56.5 ± 12.5

< 0.001

MAP_pre, mm Hg

78.7 ± 15.8

76.5 ± 16.3

0.39

LAP_pre, mm Hg

7.9 ± 4.4

5.3 ± 3.3

< 0.001

Intraprocedural comparison

Total infusion, mL

1,120.6 ± 420.2

999.7 ± 379.6

0.071

Sedatives

Dexmedetomidine, µg

73.8 ± 25.2

74.8 ± 37.2

0.84

Fentanyl, mg

0.16 ± 0.05

0.17 ± 0.06

0.26

Diazepam, mg

8.4 ± 3.5

9.1 ± 4.5

0.32

Thiopental, mg

90.1 ± 41.8

N/A

Contrast agent, mL

28.1 ± 11.6

28.2 ± 9.9

0.96

The time after SR restoration, min

18.5 ± 15.5

N/A

Procedure time, min

168.3 ± 46.4

159.5 ± 52.3

0.29

Post-measurement

HR_post, bpm

66.2 ± 10.7

65.6 ± 10.9

0.71

SBP_post, mm Hg

110.7 ± 26.0

120.6 ± 24.5

0.019

DBP_post, mm Hg

65.7 ± 15.0

65.3 ± 13.0

0.86

MAP_post, mm Hg

83.7 ± 19.4

87.4 ± 16.7

0.21

LAP_post, mm Hg

12.1 ± 4.0

8.8 ± 3.9

< 0.001

**Table 3.** Comparison of Intraprocedural Parameters Among the AF Classification Groups
	PAF group (n = 5)	PerAF group (n = 48)	LSPAF group (n = 21)	PAF vs. PerAF vs. LSPAF P value
DBP: diastolic blood pressure; HR: heart rate; LAP: left atrial pressure; LSPAF: long-standing persistent atrial fibrillation; MAP: mean arterial pressure; PAF: paroxysmal atrial fibrillation; PerAF: persistent atrial fibrillation; SBP: systolic blood pressure; SR: sinus rhythm.
Pre-measurement
HR_pre, bpm	93.4 ± 38.3	85.4 ± 19.8	73.4 ± 11.8	0.033
SBP_pre, mm Hg	73.6 ± 15.8	101.9 ± 20.7	104.8 ± 20.6	0.0099
DBP_pre, mm Hg	48.2 ± 11.5	65.6 ± 12.5	65.5 ± 11.8	0.012
MAP_pre, mm Hg	59.6 ± 13.1	80.2 ± 15.6	80.0 ± 14.5	0.017
LAP_pre, mm Hg	6.2 ± 3.0	8.0 ± 4.9	8.0 ± 3.3	0.67
Intraprocedural comparison
Total infusion, mL	1,283.2 ± 544.4	1,107.2 ± 418.3	1,112.5 ± 408.6	0.67
Sedatives
Dexmedetomidine, µg	77.6 ± 29.3	70.0 ± 25.5	81.4 ± 22.8	0.21
Fentanyl, mg	0.14 ± 0.065	0.16 ± 0.047	0.186 ± 0.064	0.21
Diazepam, mg	7.0 ± 2.0	8.4 ± 3.8	8.9 ± 3.0	0.54
Thiopental, mg	115.0 ± 57.6	87.5 ± 38.9	91.7 ± 44.3	0.375
Contrast agent, mL	29.4 ± 6.3	29.1 ± 11.5	25.6 ± 12.7	0.5
Procedure time, min	177.2 ± 57.7	165.2 ± 45.1	173.1 ± 48.4	0.73
The time after SR restoration, min	10.0 ± 6.3	21.5 ± 15.5	17.0 ± 8.1	0.29
Post-measurement
HR_post, bpm	66.8 ± 21.3	66.6 ± 9.6	65.1 ± 10.4	0.85
SBP_post, mm Hg	113.4 ± 28.5	110.7 ± 26.6	110.1 ± 25.1	0.96
DBP_post, mm Hg	62.4 ± 17.3	65.6 ± 13.7	66.8 ± 17.8	0.84
MAP_post, mm Hg	83.6 ± 23.1	83.2 ± 18.8	84.5 ± 20.7	0.97
LAP_post, mm Hg	11.8 ± 2.0	12.1 ± 4.7	12.1 ± 2.4	0.98

Table 3. Comparison of Intraprocedural Parameters Among the AF Classification Groups

PAF group (n = 5)

PerAF group (n = 48)

LSPAF group (n = 21)

PAF vs. PerAF vs. LSPAF P value

DBP: diastolic blood pressure; HR: heart rate; LAP: left atrial pressure; LSPAF: long-standing persistent atrial fibrillation; MAP: mean arterial pressure; PAF: paroxysmal atrial fibrillation; PerAF: persistent atrial fibrillation; SBP: systolic blood pressure; SR: sinus rhythm.

Pre-measurement

HR_pre, bpm

93.4 ± 38.3

85.4 ± 19.8

73.4 ± 11.8

0.033

SBP_pre, mm Hg

73.6 ± 15.8

101.9 ± 20.7

104.8 ± 20.6

0.0099

DBP_pre, mm Hg

48.2 ± 11.5

65.6 ± 12.5

65.5 ± 11.8

0.012

MAP_pre, mm Hg

59.6 ± 13.1

80.2 ± 15.6

80.0 ± 14.5

0.017

LAP_pre, mm Hg

6.2 ± 3.0

8.0 ± 4.9

8.0 ± 3.3

0.67

Intraprocedural comparison

Total infusion, mL

1,283.2 ± 544.4

1,107.2 ± 418.3

1,112.5 ± 408.6

0.67

Sedatives

Dexmedetomidine, µg

77.6 ± 29.3

70.0 ± 25.5

81.4 ± 22.8

0.21

Fentanyl, mg

0.14 ± 0.065

0.16 ± 0.047

0.186 ± 0.064

0.21

Diazepam, mg

7.0 ± 2.0

8.4 ± 3.8

8.9 ± 3.0

0.54

Thiopental, mg

115.0 ± 57.6

87.5 ± 38.9

91.7 ± 44.3

0.375

Contrast agent, mL

29.4 ± 6.3

29.1 ± 11.5

25.6 ± 12.7

0.5

Procedure time, min

177.2 ± 57.7

165.2 ± 45.1

173.1 ± 48.4

0.73

The time after SR restoration, min

10.0 ± 6.3

21.5 ± 15.5

17.0 ± 8.1

0.29

Post-measurement

HR_post, bpm

66.8 ± 21.3

66.6 ± 9.6

65.1 ± 10.4

0.85

SBP_post, mm Hg

113.4 ± 28.5

110.7 ± 26.6

110.1 ± 25.1

0.96

DBP_post, mm Hg

62.4 ± 17.3

65.6 ± 13.7

66.8 ± 17.8

0.84

MAP_post, mm Hg

83.6 ± 23.1

83.2 ± 18.8

84.5 ± 20.7

0.97

LAP_post, mm Hg

11.8 ± 2.0

12.1 ± 4.7

12.1 ± 2.4

0.98

**Table 4.** Comparison of Intraprocedural Parameters Among the Quartile AF-HR Groups
	Lowest Q (n = 18)	Second Q (n = 18)	Third Q (n = 18)	Highest Q (n = 20)	P value
AF: atrial fibrillation; DBP: diastolic blood pressure; HR: heart rate; LAP: left atrial pressure; MAP: mean arterial pressure; Q: quartile; SBP: systolic blood pressure; SR: sinus rhythm.
Pre-measurement
HR_pre, bpm	57.7 ± 7.4	74.0 ± 2.9	86.1 ± 6.0	109.3 ± 8.1	< 0.001
SBP_pre, mm Hg	102.9 ± 21.7	107.9 ± 23.3	96.2 ± 19.1	96.8 ± 21.2	0.3
DBP_pre, mm Hg	60.7 ± 14.6	64.9 ± 12.6	65.3 ± 12.0	66.5 ± 12.5	0.56
MAP_pre, mm Hg	75.1 ± 15.9	82.4 ± 16.9	77.9 ± 15.2	79.5 ± 15.7	0.58
LAP_pre, mm Hg	7.1 ± 3.4	8.5 ± 5.1	6.6 ± 3.3	9.3 ± 5.1	0.2
Intraprocedural comparison
Total infusion, mL	1,178.9 ± 496.4	1,150.6 ± 425.4	1,197.8 ± 373.1	971.7 ± 372.1	0.32
Sedatives
Dexmedetomidine, µg	73.0 ± 22.0	70.2 ± 23.4	82.4 ± 27.4	69.8 ± 27.3	0.4
Fentanyl, mg	0.169 ± 0.049	0.181 ± 0.055	0.181 ± 0.057	0.138 ± 0.048	0.039
Diazepam, mg	8.1 ± 4.0	8.1 ± 2.6	10.0 ± 4.1	7.6 ± 2.8	0.19
Thiopental, mg	95.8 ± 41.3	81.9 ± 36.2	95.8 ± 46.4	88.8 ± 44.0	0.72
Contrast agent, mL	29.8 ± 6.8	30.2 ± 13.5	24.6 ± 12.8	27.9 ± 12.1	0.45
Procedure time, min	187.8 ± 49.8	153.6 ± 40.8	177.8 ± 44.6	155.9 ± 45.0	0.064
The time after SR restoration, min	17.0 ± 17.5	13.5 ± 8.5	20.0 ± 11.5	25.0 ± 15.8	0.97
Post-measurement
HR_post, bpm	61.6 ± 12.2	64.4 ± 9.9	66.2 ± 8.1	72.1 ± 10.1	0.016
SBP_post, mm Hg	120.1 ± 27.2	115.2 ± 32.7	98.5 ± 17.0	109.4 ± 21.7	0.072
DBP_post, mm Hg	68.2 ± 18.4	66.1 ± 17.9	62.6 ± 10.8	66.1 ± 12.5	0.73
MAP_post, mm Hg	89.1 ± 21.6	85.8 ± 23.6	77.2 ± 13.1	82.6 ± 17.3	0.3
LAP_post, mm Hg	11.8 ± 3.2	13.6 ± 2.7	10.4 ± 3.3	12.5 ± 5.6	0.12

Table 4. Comparison of Intraprocedural Parameters Among the Quartile AF-HR Groups

Lowest Q (n = 18)

Second Q (n = 18)

Third Q (n = 18)

Highest Q (n = 20)

P value

AF: atrial fibrillation; DBP: diastolic blood pressure; HR: heart rate; LAP: left atrial pressure; MAP: mean arterial pressure; Q: quartile; SBP: systolic blood pressure; SR: sinus rhythm.

Pre-measurement

HR_pre, bpm

57.7 ± 7.4

74.0 ± 2.9

86.1 ± 6.0

109.3 ± 8.1

< 0.001

SBP_pre, mm Hg

102.9 ± 21.7

107.9 ± 23.3

96.2 ± 19.1

96.8 ± 21.2

0.3

DBP_pre, mm Hg

60.7 ± 14.6

64.9 ± 12.6

65.3 ± 12.0

66.5 ± 12.5

0.56

MAP_pre, mm Hg

75.1 ± 15.9

82.4 ± 16.9

77.9 ± 15.2

79.5 ± 15.7

0.58

LAP_pre, mm Hg

7.1 ± 3.4

8.5 ± 5.1

6.6 ± 3.3

9.3 ± 5.1

0.2

Intraprocedural comparison

Total infusion, mL

1,178.9 ± 496.4

1,150.6 ± 425.4

1,197.8 ± 373.1

971.7 ± 372.1

0.32

Sedatives

Dexmedetomidine, µg

73.0 ± 22.0

70.2 ± 23.4

82.4 ± 27.4

69.8 ± 27.3

0.4

Fentanyl, mg

0.169 ± 0.049

0.181 ± 0.055

0.181 ± 0.057

0.138 ± 0.048

0.039

Diazepam, mg

8.1 ± 4.0

8.1 ± 2.6

10.0 ± 4.1

7.6 ± 2.8

0.19

Thiopental, mg

95.8 ± 41.3

81.9 ± 36.2

95.8 ± 46.4

88.8 ± 44.0

0.72

Contrast agent, mL

29.8 ± 6.8

30.2 ± 13.5

24.6 ± 12.8

27.9 ± 12.1

0.45

Procedure time, min

187.8 ± 49.8

153.6 ± 40.8

177.8 ± 44.6

155.9 ± 45.0

0.064

The time after SR restoration, min

17.0 ± 17.5

13.5 ± 8.5

20.0 ± 11.5

25.0 ± 15.8

0.97

Post-measurement

HR_post, bpm

61.6 ± 12.2

64.4 ± 9.9

66.2 ± 8.1

72.1 ± 10.1

0.016

SBP_post, mm Hg

120.1 ± 27.2

115.2 ± 32.7

98.5 ± 17.0

109.4 ± 21.7

0.072

DBP_post, mm Hg

68.2 ± 18.4

66.1 ± 17.9

62.6 ± 10.8

66.1 ± 12.5

0.73

MAP_post, mm Hg

89.1 ± 21.6

85.8 ± 23.6

77.2 ± 13.1

82.6 ± 17.3

0.3

LAP_post, mm Hg

11.8 ± 3.2

13.6 ± 2.7

10.4 ± 3.3

12.5 ± 5.6

0.12

**Table 5.** Comparison of Intraprocedural Parameters Among the Quartile LAD Groups
	Lowest Q (n = 17)	Second Q (n = 19)	Third Q (n = 19)	Highest Q (n = 19)	P value
AF: atrial fibrillation; DBP: diastolic blood pressure; HR: heart rate; LAD: left atrial dimension; LAP: left atrial pressure; MAP: mean arterial pressure; Q: quartile; SBP: systolic blood pressure; SR: sinus rhythm.
LAD, mm	37.0 ± 2.9	41.8 ± 0.8	45.2 ± 1.3	51.3 ± 3.1	< 0.001
Pre-measurement
HR_pre, bpm	89.9 ± 21.9	89.4 ± 21.5	73.5 ± 13.7	78.1 ± 19.4	0.023
SBP_pre, mm Hg	97.4 ± 28.2	106.3 ± 21.0	96.9 ± 17.0	102.4 ± 19.3	0.5
DBP_pre, mm Hg	62.5 ± 14.5	69.2 ± 11.3	60.5 ± 10.6	65.1 ± 14.2	0.19
MAP_pre, mm Hg	76.9 ± 20.1	84.2 ± 14.2	75.2 ± 12.9	78.4 ± 15.5	0.33
LAP_pre, mm Hg	7.4 ± 4.6	8.6 ± 3.7	7.8 ± 4.9	7.7 ± 4.6	0.87
Intraprocedural comparison
Total infusion, mL	1,087.1 ± 428.5	1,125.9 ± 374.2	1,176.8 ± 461.9	1,089.4 ± 440.7	0.91
Sedatives
Dexmedetomidine, µg	71.5 ± 23.8	72.5 ± 22.3	76.4 ± 27.1	74.7 ± 28.9	0.94
Fentanyl, mg	0.156 ± 0.053	0.176 ± 0.061	0.176 ± 0.051	0.155 ± 0.052	0.45
Diazepam, mg	7.4 ± 3.4	9.0 ± 3.8	7.5 ± 2.8	10.0 ± 3.7	0.067
Thiopental, mg	89.7 ± 42.4	76.3 ± 32.8	97.4 ± 46.3	98.7 ± 43.7	0.33
Contrast agent, mL	28.4 ± 10.1	27.0 ± 11.7	30.1 ± 13.3	26.9 ± 11.6	0.82
Procedure time, min	160.5 ± 43.9	172.0 ± 40.9	165.4 ± 44.4	174.8 ± 57.5	0.8
The time after SR restoration, min	29.0 ± 14.5	25.0 ± 16.6	19.0 ± 13.6	17.0 ± 7.0	0.84
Post-measurement
HR_post, bpm	66.0 ± 14.0	68.9 ± 9.4	64.6 ± 8.6	65.3 ± 10.8	0.63
SBP_post, mm Hg	108.1 ± 23.5	109.7 ± 23.4	105.8 ± 29.7	119.0 ± 26.7	0.43
DBP_post, mm Hg	61.6 ± 12.1	67.4 ± 13.8	63.3 ± 17.2	70.2 ± 15.9	0.31
MAP_post, mm Hg	81.1 ± 16.2	83.7 ± 18.8	79.9 ± 22.3	89.6 ± 19.5	0.43
LAP_post, mm Hg	10.2 ± 3.9	12.2 ± 4.2	13.9 ± 3.6	11.8 ± 3.7	0.044

Table 5. Comparison of Intraprocedural Parameters Among the Quartile LAD Groups

Lowest Q (n = 17)

Second Q (n = 19)

Third Q (n = 19)

Highest Q (n = 19)

P value

AF: atrial fibrillation; DBP: diastolic blood pressure; HR: heart rate; LAD: left atrial dimension; LAP: left atrial pressure; MAP: mean arterial pressure; Q: quartile; SBP: systolic blood pressure; SR: sinus rhythm.

LAD, mm

37.0 ± 2.9

41.8 ± 0.8

45.2 ± 1.3

51.3 ± 3.1

< 0.001

Pre-measurement

HR_pre, bpm

89.9 ± 21.9

89.4 ± 21.5

73.5 ± 13.7

78.1 ± 19.4

0.023

SBP_pre, mm Hg

97.4 ± 28.2

106.3 ± 21.0

96.9 ± 17.0

102.4 ± 19.3

0.5

DBP_pre, mm Hg

62.5 ± 14.5

69.2 ± 11.3

60.5 ± 10.6

65.1 ± 14.2

0.19

MAP_pre, mm Hg

76.9 ± 20.1

84.2 ± 14.2

75.2 ± 12.9

78.4 ± 15.5

0.33

LAP_pre, mm Hg

7.4 ± 4.6

8.6 ± 3.7

7.8 ± 4.9

7.7 ± 4.6

0.87

Intraprocedural comparison

Total infusion, mL

1,087.1 ± 428.5

1,125.9 ± 374.2

1,176.8 ± 461.9

1,089.4 ± 440.7

0.91

Sedatives

Dexmedetomidine, µg

71.5 ± 23.8

72.5 ± 22.3

76.4 ± 27.1

74.7 ± 28.9

0.94

Fentanyl, mg

0.156 ± 0.053

0.176 ± 0.061

0.176 ± 0.051

0.155 ± 0.052

0.45

Diazepam, mg

7.4 ± 3.4

9.0 ± 3.8

7.5 ± 2.8

10.0 ± 3.7

0.067

Thiopental, mg

89.7 ± 42.4

76.3 ± 32.8

97.4 ± 46.3

98.7 ± 43.7

0.33

Contrast agent, mL

28.4 ± 10.1

27.0 ± 11.7

30.1 ± 13.3

26.9 ± 11.6

0.82

Procedure time, min

160.5 ± 43.9

172.0 ± 40.9

165.4 ± 44.4

174.8 ± 57.5

0.8

The time after SR restoration, min

29.0 ± 14.5

25.0 ± 16.6

19.0 ± 13.6

17.0 ± 7.0

0.84

Post-measurement

HR_post, bpm

66.0 ± 14.0

68.9 ± 9.4

64.6 ± 8.6

65.3 ± 10.8

0.63

SBP_post, mm Hg

108.1 ± 23.5

109.7 ± 23.4

105.8 ± 29.7

119.0 ± 26.7

0.43

DBP_post, mm Hg

61.6 ± 12.1

67.4 ± 13.8

63.3 ± 17.2

70.2 ± 15.9

0.31

MAP_post, mm Hg

81.1 ± 16.2

83.7 ± 18.8

79.9 ± 22.3

89.6 ± 19.5

0.43

LAP_post, mm Hg

10.2 ± 3.9

12.2 ± 4.2

13.9 ± 3.6

11.8 ± 3.7

0.044