Catheter ablation of atrial fibrillation in heart failure: clinical, prognostic, and echocardiographic outcome
- 1 April 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of Interventional Cardiac Electrophysiology
- Vol. 60 (2), 221-229
- https://doi.org/10.1007/s10840-020-00727-9
Abstract
Purpose Catheter ablation (CA) for atrial fibrillation (AF) in heart failure (HF) patients is associated with a lower rate of cardiac events compared with medical therapy. This study deals with the clinical, echocardiographic, and prognostic outcomes in these patients. Prognostic scores, as MAGGIC (Meta-analysis Global Group in Chronic Heart Failure) score, may help to predict the outcomes. Methods From a single center, 47 patients with AF, HF, and left ventricular ejection fraction (LVEF) < 50% underwent CA. The primary endpoints were NYHA functional class, LVEF, and MAGGIC score. Results The median age of patients was 59 years; 49% had paroxysmal AF. At 12 months, a significant improvement of NYHA class (median before II [interquartile range (IQR) II-III] vs median after I [IQR I-II]) and of LVEF (median before 44% [IQR 37–47] vs median after 55% [IQR49–57]) was observed (p value < 0.001). The MAGGIC 1-year and 3-year probability of death was estimated before (mean score 13 [IQR 11–17]) and at 12-month (mean score 11 [IQR 8–13]), showing a significant decrease in the probability of death (p value p value 0.035). Coronary artery disease (CAD) (HR 5, p value 0.035) and MAGGIC score (HR 1.2, p value 0.030) were predictors of HF hospitalization. Conclusions CA for AF in HF patients was associated with a significant improvement of NYHA functional class and LVEF and a higher life expectation. CAD history, LVEF < 40%, and MAGGIC score before ablation were predictors of HF hospitalization.Keywords
This publication has 26 references indexed in Scilit:
- Atrial Fibrillation Begets Heart Failure and Vice VersaCirculation, 2016
- Atrial fibrillation and heart failure due to reduced versus preserved ejection fraction: A systematic review and meta-analysis of death and adverse outcomesInternational Journal of Cardiology, 2015
- Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular ImagingEuropean Heart Journal – Cardiovascular Imaging, 2015
- Response to Letter Regarding “Catheter Ablation of Atrial Fibrillation in Patients With Left Ventricular Systolic Dysfunction: A Systematic Review and Meta-Analysis”Circulation: Arrhythmia and Electrophysiology, 2015
- Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular ImagingJournal of the American Society of Echocardiography, 2015
- Catheter Ablation of Atrial Fibrillation in Patients With Left Ventricular Systolic DysfunctionCirculation: Arrhythmia and Electrophysiology, 2014
- Long-term follow-up after atrial fibrillation ablation in patients with impaired left ventricular systolic function: The importance of rhythm and rate controlHeart Rhythm, 2013
- CHADS2 and CHA2DS2-VASc scores as predictors of left atrial ablation outcomes for paroxysmal atrial fibrillationEP Europace, 2013
- Effects of circumferential or segmental pulmonary vein ablation for paroxysmal atrial fibrillation on cardiac autonomic functionHeart Rhythm, 2006
- Late recurrent arrhythmias after ablation of atrial fibrillation: Incidence, mechanisms, and treatmentHeart Rhythm, 2004