The Impact of Known Heart Disease on Long-Term Outcomes of Catheter Ablation in Patients with Atrial Fibrillation and Left Ventricular Systolic Dysfunction: A Multicenter International Study.
In: Journal of Cardiovascular Electrophysiology, Jg. 27 (2016-03-01), Heft 3, S. 281-289
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Zugriff:
The Impact of Known Heart Disease on AF Ablation Outcomes Background Catheter ablation for AF is an effective treatment for patients with AF and systolic LV dysfunction; however, the clinical outcome is variable. We evaluated the impact of cardiomyopathy etiology on long-term outcomes post-catheter ablation. Methods Patients undergoing AF ablation across 3 centers (2 Australian, 1 UK) from 2002 to 2014, with LVEF<45% were evaluated. Patients were stratified into those with known heart disease as a cause of cardiomyopathy (KHD), and those with idiopathic dilated cardiomyopathy (IDCM). Results One hundred and one patients (IDCM = 77, KHD = 24) with AF and LVEF <45% underwent AF ablation. The KHD group (ischemic HD in 67%) were older (61 ± 7 vs. 55 ± 11 years, P = 0.005), with a higher CHADS 2 score (2.0 ± 0.8 vs. 1.6 ± 0.7, P = 0.016), but otherwise well matched. After mean follow-up of 36 ± 23 months, AF control was greater in the IDCM group (82% vs. 50% in KHD, P < 0.001). On multivariate analysis IDCM was associated with long-term AF control (P = 0.033). The IDCM group had less functional impairment at follow-up (NYHA class 1.5 ± 0.7 vs. 2.0 ± 0.8, P = 0.005) and improved LVEF (50 ± 11% vs. 38 ± 10%, P < 0.001). Super responders (EF improvement >15%) were overwhelmingly in the IDCM group (94% vs. 6%, P < 0.001) with greater AF control (89% vs. 61%, P < 0.001). All-cause mortality was significantly higher in the KHD group (17% vs. 1.3%, P = 0.002). Conclusion IDCM was associated with greater AF control, and improvement in symptoms and LVEF compared to patients with KHD post-AF ablation. AF is an important reversible cause of HF in patients with an unexplained CM and catheter ablation an effective treatment option. [ABSTRACT FROM AUTHOR]
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The Impact of Known Heart Disease on Long-Term Outcomes of Catheter Ablation in Patients with Atrial Fibrillation and Left Ventricular Systolic Dysfunction: A Multicenter International Study.
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Autor/in / Beteiligte Person: | PRABHU, SANDEEP ; LING, LIANG‐HAN ; ULLAH, WAQAS ; HUNTER, ROSS J. ; SCHILLING, RICHARD J. ; McLELLAN, ALEX J.A. ; EARLEY, MARK J. ; SPORTON, SIMON C. ; VOSKOBOINIK, ALEX ; BLUSZTEIN, DAVID ; MARIANI, JUSTIN A. ; LEE, GEOFFREY ; TAYLOR, ANDREW J. ; KALMAN, JONATHAN M. ; KISTLER, PETER M. |
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Zeitschrift: | Journal of Cardiovascular Electrophysiology, Jg. 27 (2016-03-01), Heft 3, S. 281-289 |
Veröffentlichung: | 2016 |
Medientyp: | academicJournal |
ISSN: | 1045-3873 (print) |
DOI: | 10.1111/jce.12899 |
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