Catheter ablation for atrial fibrillation in patients with congestive heart failure. (15th June 2021)

• Record Type: Journal Article
• Authors: Nitta, Giichi; Inaba, Osamu; Kato, Shunichi; Kono, Toshikazu; Ikenouchi, Takashi; Murata, Kazuya; Hada, Yasuaki; Kanoh, Miki; Takamiya, Tomomasa; Inamura, Yukihiro; Negi, Ken; Sato, Akira; Yamato, Tsunehiro; Matsumura, Yutaka; Eguchi, Kazuo; Nitta, Junichi; Takahashi, Yoshihide; Goya, Masahiko; Sasano, Tetsuo
• Is Part Of: International journal of cardiology. Volume 333(2021)
• Page Start: 98
• Page End: 104
• Publication Date: 2021-06-15
• Subjects: Catheter ablation -- Atrial fibrillation -- Heart failure -- Arrhythmia-induced cardiomyopathy -- Success rate; 3D 3-dimensional -- AAD antiarrhythmic drug -- AF atrial fibrillation -- AIC Arrhythmia-induced cardiomyopathy -- APBs atrial premature beats -- AT atrial tachycardia -- BNP brain natriuretic peptide -- CA Catheter ablation -- CB cryoballoon -- CHF congestive heart failure -- CIs confidence intervals -- CT computed tomography -- EF ejection fraction -- HF heart failure -- HFpEF HF with preserved EF -- HFrEF HF with reduced ejection fraction -- HRs hazard ratios -- LA left atrial -- LAD LA diameter -- LV left ventricular -- LVEF left ventricular ejection fraction -- LVSD LV systolic dysfunction -- OHDs organic heart diseases -- PVI pulmonary vein isolation -- RF radiofrequency -- TTE transthoracic echocardiogram; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2021.02.060
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: We evaluated the 1-year success rate of maintaining sinus rhythm after catheter ablation (CA) for atrial fibrillation (AF) in patients with or without congestive heart failure (CHF). Methods: In this single-centre retrospective matched-pair cohort study of 3, 018 AF patients who underwent initial CA between January 2012 and June 2018, 227 pairs with (CHF group) or without CHF (control group) were matched using propensity scores. In the CHF group, 108 patients were assigned to the arrhythmia-induced cardiomyopathy (AIC) group whose left ventricular systolic dysfunction was explained only by lasting AF or atrial tachycardia; the remaining 119 had organic heart diseases (non-AIC group). We evaluated the 1-year AF-free survival and changes in clinical findings before and after CA. Results: The CHF and control groups showed similar AF-free survival; however, AIC patients had significantly better survival than non-AIC patients. AF recurrence was significantly related to CHF re-hospitalisation, which was significantly more frequent in the non-AIC group than in the AIC group. The clinical outcomes of left atrial dilation, brain natriuretic peptide level, and left ventricular ejection function improved significantly before and after CA in both groups. The degree of improvement was significantly better in the AIC group than in the non-AIC group. Conclusions: The 1-year success rate was not significantly different between the CHF and control groups. The 1-year success rate in the AIC group was similar to that in the AIC-control group and was better than that in the non-AIC group. CHF clinical outcomes were improved significantly. Highlights: Retrospective matched-pair cohort study was performed. We compared success rates in congestive heart failure (CHF) vs. control patients. Their 1-year success rates after catheter ablation (CA) were similar. The 1-year success rate after CA was similar for AIC-group vs. AIC-control group. The CHF group had higher 1-year success rate after CA in AIC than non-AIC patients.