Atrial fibrillation ablation in congestive heart failure with preserved ejection fraction: Tackling the vicious twins

Qin, Dingxin; Heist, E. Kevin

doi:10.1111/jce.14370

Cited by 5 publications

(1 citation statement)

References 13 publications

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“…This results in increased cardiac filling pressures at rest associated with a progressive decline in the passive properties of the left ventricle ( Pieske et al, 2019 ). Other factors also contribute to the overall pathophysiology of the disease including ventricular desynchrony, increased left atrial pressure, pulmonary congestion, and atrial fibrillation ( Qin and Heist, 2020 ). Many of these abnormalities are not present at rest and manifest only during cardiac stress (i.e., exercise) or during decompensation ( Houstis et al, 2018 ; Lam et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Potential Role of the Retrotrapezoid Nucleus in Mediating Cardio-Respiratory Dysfunction in Heart Failure With Preserved Ejection Fraction

et al. 2022

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A strong association between chemoreflex hypersensitivity, disordered breathing, and elevated sympathetic activity has been shown in experimental and human heart failure (HF). The contribution of chemoreflex hypersensitivity in HF pathophysiology is incompletely understood. There is ample evidence that increased peripheral chemoreflex drive in HF with reduced ejection fraction (HFrEF; EF<40%) leads to pathophysiological changes in autonomic and cardio-respiratory control, but less is known about the neural mechanisms mediating cardio-respiratory disturbances in HF with preserved EF (HFpEF; EF>50%). Importantly, it has been shown that activation of the central chemoreflex worsens autonomic dysfunction in experimental HFpEF, an effect mediated in part by the activation of C1 catecholaminergic neurons neighboring the retrotrapezoid nucleus (RTN), an important region for central chemoreflex control of respiratory and autonomic function. Accordingly, the main purpose of this brief review is to discuss the possible role played by activation of central chemoreflex pathways on autonomic function and its potential role in precipitating disordered breathing in HFpEF. Improving understanding of the contribution of the central chemoreflex to the pathophysiology of HFpEF may help in development of novel interventions intended to improve cardio-respiratory outcomes in HFpEF.

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Section: Introductionmentioning

confidence: 99%

Potential Role of the Retrotrapezoid Nucleus in Mediating Cardio-Respiratory Dysfunction in Heart Failure With Preserved Ejection Fraction

et al. 2022

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Predicting factors of heart arrhythmia in patients with permanent heart pacemaker

Vu,

Le,

Nguyen

2024

Preprint

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Purpose: Identify some factors predicting arrhythmia after permanent pacemaker placement to treat atrioventricular block and sinus node dysfunction. Methods: Prospective study in 312 patients with permanent pacemakers due to atrioventricular block and sinus node dysfunction being monitored at Thong Nhat Hospital and Thu Duc city hospital from March 2022 to September 2022 Results: The rate of arrhythmia after pacemaker insertion was 41%, of which 20.2% atrial fibrillation; 10.9% atrial tachycardia; 1.3% sinus arrest; 9.9% ventricular premature beats; 1.3% ventricular tachycardia and 2.2% supraventricular tachycardia. Factors that determine the possibility of arrhythmia after permanent pacemaker placement include ejection fraction index, blood potassium, blood chloride, blood HDL-Cholesterol concentration, smoking and pacemaker mode (VVIR). /DDDR). Conclusions: Cardiac arrhythmia in patients with permanent pacemakers is always likely to occur, related factors predict 57.8% of the possibility of this event occurring.

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Long‐Term Outcome of Left Heart Function after Catheter Ablation in Patients with Persistent Atrial Fibrillation Combined with Preserved Ejection Fraction Heart Failure

Liu,

Zhang,

Zhao

et al. 2024

Journal of Interventional Cardiology

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Objective. We aimed to examine the benefits of catheter ablation on left heart structure and function in patients with persistent atrial fibrillation (AF) accompanied by heart failure (HF) with preserved ejection fraction (HFpEF), in comparison with the benefits in patients with AF accompanied by HF with reduced ejection fraction (HFrEF) or patients with no HF. Methods. A total of 399 patients with nonvalvular persistent AF who underwent catheter ablation from 2015 to 2021 were retrospectively included sixty‐seven patients with recurrence of AF within 1 year were excluded, as well as 53 patients who failed to be followed up at (12 ± 1) months after the procedure. Finally, 279 patients who fulfilled the criteria were included and divided into these groups: the HFpEF group (left ventricular ejection fraction (LVEF) ≥50% and N‐Terminal Pro‐Brain Natriuretic Peptide (NT‐proBNP) ≥125 pg/ml or E/e′ ≥15, n = 116), HFrEF group (LVEF <50%, n = 48), and no HF group (NT‐proBNP <125 pg/ml, n = 115). The endpoints were changes in image‐based functional status from baseline to 1 year, including echocardiogram and speckle‐tracking echocardiography. Results. The left atrial structure of patients with HFpEF decreased significantly 1 year after catheter ablation (left atrial anteroposterior dimension: 41.48 ± 4.53 mm vs. 38.64 ± 4.40; left atrial mediolateral dimension: 41.99 ± 5.52 vs. 38.24 ± 4.63 mm; left atrial superoinferior dimension: 61.36 ± 6.73 vs. 56.44 ± 6.97 mm). The left atrial and left ventricular volumes were significantly reduced and the ejection fraction was increased in all three groups, with HFrEF patients benefiting more. In the speckle‐tracking echocardiography indexes, significant improvements were observed in left atrial strain (16.83 ± 6.91 vs. 28.05 ± 9.92), left atrial storage function (0.97 ± 0.38 vs. 1.49 ± 0.58), and left atrial pump function (−1.15 ± 0.55 vs. −1.68 ± 0.75) among HFpEF patients after 1 year, with no changes in left atrial conduit function (−1.55 ± 0.62 vs. −1.50 ± 0.54). In addition to the above improvements in left atrial structure and function, there was no significant improvement in left ventricular diastolic function in patients with HFpEF (E/e′, 14.11 ± 5.52 vs. 14.30 ± 7.25, P = 0.85). Conclusion. Catheter ablation is beneficial in restoring sinus rhythm in patients with persistent AF with coexisting HFpEF, significantly decreasing the left atrial size, improving left atrial storage function and left atrial pump function, and increasing left atrial and left ventricular ejection fraction.

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Atrial fibrillation ablation in congestive heart failure with preserved ejection fraction: Tackling the vicious twins

Cited by 5 publications

References 13 publications

Potential Role of the Retrotrapezoid Nucleus in Mediating Cardio-Respiratory Dysfunction in Heart Failure With Preserved Ejection Fraction

Potential Role of the Retrotrapezoid Nucleus in Mediating Cardio-Respiratory Dysfunction in Heart Failure With Preserved Ejection Fraction

Predicting factors of heart arrhythmia in patients with permanent heart pacemaker

Long‐Term Outcome of Left Heart Function after Catheter Ablation in Patients with Persistent Atrial Fibrillation Combined with Preserved Ejection Fraction Heart Failure

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