Atrial Fibrillation in Heart Failure Patients with Preserved or Reduced Ejection Fraction. Prognostic significance of Rhythm control strategy with Catheter Ablation
| Autor: | Leonardo Ripa, Lujan Talavera, Santiago Rivera, Leandro Tomas, Mirta Diez, Gastón Albina, Ignacio Mondragón, Fernando Scazzuso, Nicolás Vecchio, Adriana Acosta, Agustín Orosco |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Ejection fraction business.industry medicine.medical_treatment Rhythm control Atrial fibrillation Catheter ablation Mean age 030204 cardiovascular system & hematology medicine.disease 03 medical and health sciences 0302 clinical medicine Left atrial Internal medicine Heart failure Cardiology medicine Sinus rhythm 030212 general & internal medicine Cardiology and Cardiovascular Medicine business Original Research |
| Zdroj: | Journal of atrial fibrillation. 11(5) |
| ISSN: | 1941-6911 |
| Popis: | Introduction Atrial fibrillation (AF) and heart failure (HF) often coexist with an increase in morbidity and mortality. AF catheter ablation (CA) has proved to be a safe and efficient option for HF patients, but long-term evolution and prognosis remain uncertain. The aim is to assess the efficacy and safety of CA in HF patients with AF, and analyze HF long-term evolution. Methods We prospectively analyzed consecutive patients with AF and congestive HF or left ventricular ejection fraction (EF) less than 45%, who underwent CA of AF between 2011 and 2016. We excluded patients who did not complete one year of follow-up. Results Seventy-nine patients were included. Mean age was 62.1 years, 72.4% were men, 67.2% had hypertension and 8.6% were diabetics. Mean EF was 49%, left atrial area was 26.5 cm2 and mean CHA2DS2-VASc score was 2. 70.6% were on NYHA FC II-III.The recurrence rate of AF was 60%, and after a second CA the rate decreased to 27.8%. Only persistent AF prior to the procedure was identified as independent predictor of recurrence. There was a significant NYHA FC improvement in the sinus rhythm (SR) group vs those with recurrence (63.6% vs 36.4%; p=0.047). None of the patients in SR were hospitalized, whereas six with recurrence were hospitalized due to HF (0% vs. 18.2%; p = 0.07). The rate of complications was 9.1%. Conclusions Catheter ablation of atrial fibrillation in heart failure presents an adequate success rate, improving symptoms and reducing rehospitalizations due to heart failure. |
| Databáze: | OpenAIRE |
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