1. Comparison of Outcomes After Ablation of Atrial Fibrillation in Patients With Heart Failure With Preserved Versus Reduced Ejection Fraction
- Author
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Gregory K. Feld, Florentino Lupercio, Jonathan C. Hsu, Frederick T. Han, Praneet Mylavarapu, David E. Krummen, Kurt S. Hoffmayer, Chaitanya L Malladi, Douglas Darden, Omar M. Aldaas, Farshad Raissi, and Gordon Ho
- Subjects
Male ,complications [Atrial Fibrillation] ,medicine.medical_specialty ,medicine.medical_treatment ,Ablation of atrial fibrillation ,Catheter ablation ,030204 cardiovascular system & hematology ,Article ,surgery ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Atrial Fibrillation ,Humans ,Medicine ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Heart Failure ,Ejection fraction ,business.industry ,Hazard ratio ,Stroke Volume ,Atrial fibrillation ,Retrospective cohort study ,complications [Heart Failure] ,Stroke volume ,Middle Aged ,medicine.disease ,Treatment Outcome ,Heart failure ,Catheter Ablation ,Cardiology ,Female ,physiopathology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Catheter ablation improves outcomes in atrial fibrillation (AF) patients with heart failure (HF) with reduced ejection fraction (HFrEF). We sought to evaluate the efficacy and safety of catheter ablation of AF in HF patients with a preserved ejection fraction (HFpEF). We performed a retrospective study of all patients who underwent de novo radiofrequency catheter ablation enrolled in the UC San Diego AF Ablation Registry. The primary outcome was recurrence of all atrial arrhythmias on or off antiarrhythmic drugs (AAD). Of 547 total patients, 51 (9.3%) had HFpEF, 40 (7.3%) had HFrEF, and 456 (83.4%) were without HF. There was no difference in recurrence of atrial arrhythmias on or off AAD [Adjusted Hazard Ratio (AHR) 1.92 (95% CI 0.97-3.83) for HFpEF versus HFrEF and AHR 0.90 (95% CI 0.59-1.39) for HFpEF versus no HF] or off AAD [AHR 1.96 (95% CI 0.99-3.90) for HFpEF versus HFrEF and AHR 1.14 (95% CI 0.74-1.77) for HFpEF versus no HF]. There was also no difference in rates of all-cause hospitalizations [AHR 1.80 (95% CI 0.97-3.33) for HFpEF versus HFrEF and AHR 2.05 (95% CI 1.30-3.23) for HFpEF versus no HF] or rates of all-cause mortality [AHR 0.53 (95% CI 0.05-6.11) for HFpEF versus HFrEF and AHR 2.46 (95% CI 0.34-17.92) for HFpEF versus no HF]. There were no significant differences in AAD use (p=0.176) or procedural complications between groups (p=0.980). In conclusion, there were no significant differences in arrhythmia-free survival between patients with HFpEF and HFrEF undergoing catheter ablation of AF.
- Published
- 2020
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