A prospective evaluation of haemodynamics, functional status, and quality of life after radiofrequency catheter ablation of long-standing persistent atrial fibrillation

Fiala, Martin; Wichterle, Dan; Bůlková, Veronika; Škňouřil, Libor; Nevřalová, Renáta; Toman, Ondřej; Dorda, Miloslav; Januška, Jaroslav; Špinar, Jindřich

doi:10.1093/europace/eut161

Cited by 40 publications

(31 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, the extent of atrial ablation, which is often required to terminate persistent AF, has been repeatedly questioned, although recent studies (including reports from this population) showed that benefits from restored SR in terms of hemodynamic, functional, and quality-of life-improvement outweigh possible deleterious effects of extensive persistent AF/LSPAF ablation. 10,[13][14][15] The major findings of this study are as follows. (1) Nonrestoration of SR by ablation at the initial procedure is the dominant factor associated not only with clinical failure of the primary procedure but also with AF/AT recurrence after subsequent repeat procedure(s).…”

Section: Discussionmentioning

confidence: 85%

“…10 In brief, point-by-point ablation with an irrigatedtip catheter (NaviStar ThermoCool, Biosense Webster, Diamond Bar, CA) navigated in preacquired 3-dimensional electroanatomic maps (CARTO, Biosense Webster) of the LA and right atrium (RA) was performed off warfarin, with class I or III antiarrhythmic drugs (AADs) discontinued except for amiodarone, target activated clotting time of 300-400 seconds, irrigation at 20 mL/min, temperature 421C, and power limit of 35 W (20-25 W inside the coronary sinus [CS]). …”

Section: Preablation Examinationmentioning

confidence: 99%

See 1 more Smart Citation

Sinus rhythm restoration and arrhythmia noninducibility are major predictors of arrhythmia-free outcome after ablation for long-standing persistent atrial fibrillation: A prospective study

et al. 2015

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 85%

Section: Preablation Examinationmentioning

confidence: 99%

Sinus rhythm restoration and arrhythmia noninducibility are major predictors of arrhythmia-free outcome after ablation for long-standing persistent atrial fibrillation: A prospective study

et al. 2015

View full text Add to dashboard Cite

“…Finally, 18 studies that met the inclusion criteria were included in our meta-analysis. Among them, 10 studies 8,[12][13][14][15][16][17][18][19][20] evaluated the association between baseline BNP levels and AF recurrence after catheter ablation while the 8 other studies [21][22][23][24][25][26][27][28] investigated the potential role of NT-pro BNP. Study characteristics: The demographic and clinical properties of eligible studies are presented in Table I and Table II, respectively.…”

Section: Resultsmentioning

confidence: 99%

Association Between Baseline Natriuretic Peptides and Atrial Fibrillation Recurrence After Catheter Ablation

et al. 2016

View full text Add to dashboard Cite

SummaryNatriuretic peptides like B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-pro BNP) are reported to be increased in atrial fibrillation (AF) patients. However, the prognostic roles of BNP and NT-pro BNP in post-ablation AF recurrence remain inconclusive. We performed this meta-analysis to investigate the potential role of baseline natriuretic peptides in predicting AF recurrence after catheter ablation.Electronic databases were searched for studies that evaluated the potential relationship between AF recurrence and baseline BNP or NT-pro BNP levels. The pooled standardized mean difference (SMD) and 95% confidence interval (CI) were calculated to quantify differences in BNP or NT-pro BNP levels between patients with and without AF recurrence.Ten studies on BNP and 8 studies on NT-pro BNP were included, in which 411 of 1300 patients and 256 of 846 patients experienced AF recurrence, respectively. Overall, the pooled SMD of studies on BNP was 0.55 (95% CI: 0.26-0.84, P < 0.001) while the pooled SMD of studies on NT-pro BNP was 0.96 (95% CI: 0.62-1.30, P < 0.0001). Meta-regression was conducted by AF type, AF duration, follow-up period, left atrial dimension (LAD), and concomitant heart failure, after which subgroup analysis demonstrated only follow-up period (3 months or > 3 months) in the NT-pro BNP group might account for the heterogeneity. Sensitivity analyses indicated both the results were stable.Meta-analysis of current eligible studies suggested that both increased baseline BNP and NT-pro BNP levels are associated with greater risk of AF recurrence after catheter ablation, which could be biomarkers for predicting AF recurrence. (Int Heart J 2016; 57: 183-189) Key words: BNP, NT-pro BNP, Predictive A trial fibrillation (AF) is the most common arrhythmia and a rising global burden with progressive increases in prevalence, incidence, and AF-associated mortality during past decades. 1) Catheter ablation for rhythm control was recommended in specific patient populations with paroxysmal, persistent, or long-standing persistent AF by the latest guideline.2) However, relapse is still common since the singleprocedure efficacy of AF ablation was estimated to be 60-80% in paroxysmal AF and 50-70% in persistent AF.3) Since ablation techniques have been developed over time, the relapse rate might be partially due to the complicated pathological mechanisms and our limited knowledge of AF. Thus, stratification of patients who will sustain a better rhythm outcome after catheter ablation may be beneficial to clinical practice. Natriuretic peptides (BNP, NT-pro BNP) are primarily secreted by myocytes in response to a number of stimuli, and have been widely used as important diagnostic and monitoring tools for cardiovascular diseases. 4) Meanwhile, it has been shown that AF patients had higher plasma natriuretic peptide concentrations than controls and the elevated natriuretic peptide levels decreased when sinus rhythm was restored by transcatheter ablation.5-7) Somehow, it is inconsistent whether increase...

show abstract

“…Fifteen studies [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] meeting the prespecified inclusion criteria, and 11 long-term (≥2 years) AFCA studies, [22][23][24][25][26][27][28][29][30][31][32] for which the corresponding author was contacted and agreed to participate, were eventually included. First author, study design, publication date, and main characteristics of each included study are reported in Table 1 in the Data Supplement (Material in the Data Supplement).…”

Section: Resultsmentioning

confidence: 99%

Catheter Ablation of Atrial Fibrillation in Patients With Left Ventricular Systolic Dysfunction

Anselmino

Matta

D’Ascenzo

et al. 2014

Circ: Arrhythmia and Electrophysiology

156

View full text Add to dashboard Cite

Background— Catheter ablation of atrial fibrillation (AFCA) is an established therapeutic option for rhythm control in symptomatic patients. Its efficacy and safety among patients with left ventricular systolic dysfunction is based on small populations, and data concerning long-term outcome are limited. We performed this meta-analysis to assess safety and long-term outcome of AFCA in patients with left ventricular systolic dysfunction, to evaluate predictors of recurrence and impact on left ventricular function. Methods and Results— A systematic review was conducted in MEDLINE/PubMed and Cochrane Library. Randomized controlled trials, clinical trials, and observational studies including patients with left ventricular systolic dysfunction undergoing AFCA were included. Twenty-six studies were selected, including 1838 patients. Mean follow-up was 23 (95% confidence interval, 18–40) months. Overall complication rate was 4.2% (3.6%–4.8%). Efficacy in maintaining sinus rhythm at follow-up end was 60% (54%–67%). Meta-regression analysis revealed that time since first atrial fibrillation ( P =0.030) and heart failure ( P =0.045) diagnosis related to higher, whereas absence of known structural heart disease ( P =0.003) to lower incidence of atrial fibrillation recurrences. Left ventricular ejection fraction improved significantly during follow-up by 13% ( P <0.001), with a significant reduction of patients presenting an ejection fraction <35% ( P <0.001). N-terminal pro-brain natriuretic peptide blood levels decreased by 620 pg/mL ( P <0.001). Conclusions— AFCA efficacy in patients with impaired left ventricular systolic function improves when performed early in the natural history of atrial fibrillation and heart failure. AFCA provides long-term benefits on left ventricular function, significantly reducing the number of patients with severely impaired systolic function.

show abstract

A prospective evaluation of haemodynamics, functional status, and quality of life after radiofrequency catheter ablation of long-standing persistent atrial fibrillation

Abstract: Ablation of long-standing persistent atrial fibrillation was associated with significant recovery of haemodynamics and exercise capacity that projected onto the long-term improvement in quality of life.

Cited by 40 publications

References 30 publications

Sinus rhythm restoration and arrhythmia noninducibility are major predictors of arrhythmia-free outcome after ablation for long-standing persistent atrial fibrillation: A prospective study

Sinus rhythm restoration and arrhythmia noninducibility are major predictors of arrhythmia-free outcome after ablation for long-standing persistent atrial fibrillation: A prospective study

Association Between Baseline Natriuretic Peptides and Atrial Fibrillation Recurrence After Catheter Ablation

Catheter Ablation of Atrial Fibrillation in Patients With Left Ventricular Systolic Dysfunction

Contact Info

Product

Resources

About