BACKGROUND: Few studies have examined outcomes of catheter ablation for atrial fibrillation (AF) in patients with heart failure (HF) with preserved ejection fraction (HFpEF). OBJECTIVE: The purpose of this study was to compare outcomes of AF ablation in patients with HFpEF vs HF with reduced ejection fraction (HFrEF). METHODS: We performed a retrospective study of 230 patients with HF who underwent AF ablation, including 97 (42.2%) with HFrEF and 133 (57.8%) with HFpEF. Outcomes included adverse events, symptoms (Mayo AF Symptom Inventory [MAFSI]), New York Heart Association (NYHA) functional class, and freedom from recurrent atrial arrhythmia at 12 months. RESULTS: Overall, 150 of 230 patients had nonparoxysmal AF (62.8% HFpEF vs 63.0% HFrEF). Patients with HFpEF had a smaller mean left atrial diameter (4.4 ± 0.8 cm vs 4.7 ± 0.7 cm; P = .013) and were less likely to be taking a beta-blocker at baseline (72.9% vs 85.6%; P = .022). Median (Q1, Q3) procedure times (233 minutes [192, 290] vs 233.5 minutes [193.0, 297.5]; P = .780) and adverse events such as acute HF (3.8% vs 6.2%; P = .395) were similar between HFpEF and HFrEF patients. Freedom from recurrent atrial arrhythmia was not significantly different in HFpEF vs HFrEF patients (33.9% vs 32.6%; adjusted hazard ratio 1.47; 95% confidence interval 0.72-3.01), with similar improvements in NYHA functional class (-0.32 vs -0.19; P = .135) and MAFSI symptom severity (-0.23 vs -0.09; P = .116) after ablation. CONCLUSION: Catheter ablation of AF seems to have similar effectiveness in patients with HF, regardless of presence of systolic dysfunction. There were no significant differences in procedural characteristics, arrhythmia-free recurrence, or functional improvements between patients with HFpEF and those with HFrEF.
BACKGROUND: Few studies have examined outcomes of catheter ablation for atrial fibrillation (AF) in patients with heart failure (HF) with preserved ejection fraction (HFpEF). OBJECTIVE: The purpose of this study was to compare outcomes of AF ablation in patients with HFpEF vs HF with reduced ejection fraction (HFrEF). METHODS: We performed a retrospective study of 230 patients with HF who underwent AF ablation, including 97 (42.2%) with HFrEF and 133 (57.8%) with HFpEF. Outcomes included adverse events, symptoms (MayoAF Symptom Inventory [MAFSI]), New York Heart Association (NYHA) functional class, and freedom from recurrent atrial arrhythmia at 12 months. RESULTS: Overall, 150 of 230 patients had nonparoxysmal AF (62.8% HFpEF vs 63.0% HFrEF). Patients with HFpEF had a smaller mean left atrial diameter (4.4 ± 0.8 cm vs 4.7 ± 0.7 cm; P = .013) and were less likely to be taking a beta-blocker at baseline (72.9% vs 85.6%; P = .022). Median (Q1, Q3) procedure times (233 minutes [192, 290] vs 233.5 minutes [193.0, 297.5]; P = .780) and adverse events such as acute HF (3.8% vs 6.2%; P = .395) were similar between HFpEF and HFrEF patients. Freedom from recurrent atrial arrhythmia was not significantly different in HFpEF vs HFrEF patients (33.9% vs 32.6%; adjusted hazard ratio 1.47; 95% confidence interval 0.72-3.01), with similar improvements in NYHA functional class (-0.32 vs -0.19; P = .135) and MAFSI symptom severity (-0.23 vs -0.09; P = .116) after ablation. CONCLUSION: Catheter ablation of AF seems to have similar effectiveness in patients with HF, regardless of presence of systolic dysfunction. There were no significant differences in procedural characteristics, arrhythmia-free recurrence, or functional improvements between patients with HFpEF and those with HFrEF.
Authors: Sana M Al-Khatib; Emelia J Benjamin; Alfred E Buxton; Hugh Calkins; Mina K Chung; Anne B Curtis; Patrice Desvigne-Nickens; Pierre Jais; Douglas L Packer; Jonathan P Piccini; Yves Rosenberg; Andrea M Russo; Paul J Wang; Lawton S Cooper; Alan S Go Journal: Circulation Date: 2019-11-20 Impact factor: 29.690
Authors: Chakradhari Inampudi; Daniel Silverman; Marc A Simon; Peter J Leary; Kavita Sharma; Brian A Houston; Jean-Luc Vachiéry; Francois Haddad; Ryan J Tedford Journal: Chest Date: 2021-08-12 Impact factor: 9.410
Authors: Omar M Aldaas; Chaitanya L Malladi; Praneet S Mylavarapu; Florentino Lupercio; Douglas Darden; Frederick T Han; Kurt S Hoffmayer; David Krummen; Gordon Ho; Farshad Raissi; Gregory K Feld; Jonathan C Hsu Journal: Am J Cardiol Date: 2020-09-15 Impact factor: 2.778
Authors: Douglas L Packer; Jonathan P Piccini; Kristi H Monahan; Hussein R Al-Khalidi; Adam P Silverstein; Peter A Noseworthy; Jeanne E Poole; Tristram D Bahnson; Kerry L Lee; Daniel B Mark Journal: Circulation Date: 2021-02-08 Impact factor: 29.690
Authors: Omar M Aldaas; Florentino Lupercio; Douglas Darden; Praneet S Mylavarapu; Chaitanya L Malladi; Frederick T Han; Kurt S Hoffmayer; David Krummen; Gordon Ho; Farshad Raissi; Ulrika Birgersdotter-Green; Gregory K Feld; Jonathan C Hsu Journal: Am J Cardiol Date: 2020-12-05 Impact factor: 2.778
Authors: Benjamin A Steinberg; Mingyuan Zhang; Jason Bensch; Ann Lyons; T Jared Bunch; Jonathan P Piccini; Alfonso Siu; John A Spertus; Josef Stehlik; Peter Wohlfahrt; Tom Greene; Rachel Hess; James C Fang Journal: J Card Fail Date: 2021-07-26 Impact factor: 5.712