BACKGROUND: Heart failure (HF) promotes atrial fibrillation (AF) and AF worsens HF. This study aimed to investigate the long-term clinical outcomes after AF ablation in patients with HF. METHODS AND RESULTS: A total of 106 consecutive HF patients, including 51 (48.1%) with a reduced left ventricular ejection fraction (LVEF) (HFrEF) and 55 (51.9%) with a preserved LVEF (HFpEF), underwent AF ablation. All patients underwent successful pulmonary vein antrum isolation, and substrate modification was added in 38 (35.8%). The mean follow-up period was 32.4±18.6 months, and mean number of procedures was 1.4±0.5 per patient. Low-dose antiarrhythmic drugs were combined in 29 (27.3%) patients. Freedom from recurrent atrial arrhythmias (ATa), HF-related hospitalizations, and the composite endpoint (all-cause death, stroke, HF-related hospitalizations) at 3 years was 88.7%, 97.6%, and 97.6% in HFrEF patients, and 79.3%, 96.2%, and 91.8% in HFpEF patients, respectively. LVEF normalization (≥50%) was observed in 37 (72.5%) HFrEF patients post-ablation, and a smaller LV diastolic diameter (LVDd) was the sole predictor [odds ratio (OR)=0.863; 95% confidence interval (CI)=0.779-0.955, p=0.005]. Shortening of the LVDd (≥5mm) was observed in 16 (29.1%) HFpEF patients post-ablation, and no recurrence after the initial procedure was the sole predictor (OR=6.229; 95% CI=1.524-25.469, p=0.011). CONCLUSIONS: Catheter ablation of AF could be one of the important therapeutic options in the management of patients with HF combined with AF regardless of the type of HF.
BACKGROUND:Heart failure (HF) promotes atrial fibrillation (AF) and AF worsens HF. This study aimed to investigate the long-term clinical outcomes after AF ablation in patients with HF. METHODS AND RESULTS: A total of 106 consecutive HF patients, including 51 (48.1%) with a reduced left ventricular ejection fraction (LVEF) (HFrEF) and 55 (51.9%) with a preserved LVEF (HFpEF), underwent AF ablation. All patients underwent successful pulmonary vein antrum isolation, and substrate modification was added in 38 (35.8%). The mean follow-up period was 32.4±18.6 months, and mean number of procedures was 1.4±0.5 per patient. Low-dose antiarrhythmic drugs were combined in 29 (27.3%) patients. Freedom from recurrent atrial arrhythmias (ATa), HF-related hospitalizations, and the composite endpoint (all-cause death, stroke, HF-related hospitalizations) at 3 years was 88.7%, 97.6%, and 97.6% in HFrEF patients, and 79.3%, 96.2%, and 91.8% in HFpEF patients, respectively. LVEF normalization (≥50%) was observed in 37 (72.5%) HFrEF patients post-ablation, and a smaller LV diastolic diameter (LVDd) was the sole predictor [odds ratio (OR)=0.863; 95% confidence interval (CI)=0.779-0.955, p=0.005]. Shortening of the LVDd (≥5mm) was observed in 16 (29.1%) HFpEF patients post-ablation, and no recurrence after the initial procedure was the sole predictor (OR=6.229; 95% CI=1.524-25.469, p=0.011). CONCLUSIONS: Catheter ablation of AF could be one of the important therapeutic options in the management of patients with HF combined with AF regardless of the type of HF.
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: 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: Manuel Rattka; Alexander Pott; Anna Kühberger; Karolina Weinmann; Dominik Scharnbeck; Tilman Stephan; Michael Baumhardt; Carlo Bothner; Mario Iturbe Orbe; Wolfgang Rottbauer; Tillman Dahme Journal: Europace Date: 2020-09-01 Impact factor: 5.214