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Catheter ablation of atrial fibrillation in heart failure: clinical, prognostic, and echocardiographic outcome.
- Source :
-
Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing [J Interv Card Electrophysiol] 2021 Mar; Vol. 60 (2), pp. 221-229. Date of Electronic Publication: 2020 Apr 01. - Publication Year :
- 2021
-
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.<br />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.<br />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 <0.001). At 12-month, a lower LVEF was associated with more HF hospitalizations (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.<br />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.
Details
- Language :
- English
- ISSN :
- 1572-8595
- Volume :
- 60
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
- Publication Type :
- Academic Journal
- Accession number :
- 32239386
- Full Text :
- https://doi.org/10.1007/s10840-020-00727-9