Impact of catheter ablation of atrial fibrillation on long-term clinical outcomes in patients with heart failure

Ichijo, Sadamitsu; Miyazaki, Shinsuke; Kusa, Shigeki; Nakamura, Hiroaki; Kajiyama, Takatsugu; Iesaka, Yoshito

doi:10.1016/j.jjcc.2018.02.012

Cited by 44 publications

(62 citation statements)

References 25 publications

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“…10,[16][17][18] In contrast, catheter ablation of AF has advantages in maintaining sinus rhythm and appears to have similar effects in patients with HFpEF. [7][8][9] In fact, sinus rhythm was maintained in approximately 70% of the ABL group patients in the present study, which was consistent with the previous reports. [7][8][9] Although ABL group seemed to have advantages, Kaplan-Meier curve analysis comparing the ABL group and patients who received rhythm control by the use of amiodarone showed no significant difference regarding the maintenance of sinus rhythm in the present study.…”

Section: Predictors Of Hf Rehospitalizationsupporting

confidence: 93%

“…[7][8][9] In fact, sinus rhythm was maintained in approximately 70% of the ABL group patients in the present study, which was consistent with the previous reports. [7][8][9] Although ABL group seemed to have advantages, Kaplan-Meier curve analysis comparing the ABL group and patients who received rhythm control by the use of amiodarone showed no significant difference regarding the maintenance of sinus rhythm in the present study. This discrepancy might be due to the small number of patients and the difference in the follow-up methodology.…”

Section: Predictors Of Hf Rehospitalizationsupporting

confidence: 93%

“…In contrast, catheter ablation, mainly by pulmonary vein antrum isolation (PVAI), is performed worldwide for treating symptomatic and drug‐refractory AF patients with an acceptable success rate including patients with HFpEF 7–9 . In addition, CASTLE‐AF showed that AF ablation could reduce HF rehospitalization compared with conventional medical therapy in HF patients with reduced ejection fraction (HFrEF) 10 .…”

Section: Introductionmentioning

confidence: 99%

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Catheter ablation of atrial fibrillation reduces heart failure rehospitalization in patients with heart failure with preserved ejection fraction

Fukui

Tanino

Yamaguchi

et al. 2020

Cardiovasc electrophysiol

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Background Atrial fibrillation (AF) is associated with heart failure (HF) rehospitalization in patients with heart failure with preserved ejection fraction (HFpEF). Objective We tested the hypothesis that catheter ablation of AF could reduce HF rehospitalization compared with conventional pharmacotherapy in patients with HFpEF. Methods Eighty‐five consecutive HFpEF (EF ≥ 50% and a history of HF hospitalization) patients diagnosed as AF by 12‐lead electrocardiogram were retrospectively analyzed. Thirty‐five patients who received catheter ablation (ABL group) were compared with 50 patients treated by antiarrhythmic drugs and/or beta‐blockers (CNT group). The primary endpoint was rehospitalization due to HF. Results The patients characteristics did not differ between the two groups including, age (71 ± 8 vs 71 ± 13 years; P = .637), female sex (34% vs 36%; P = .870), mean plasma brain natriuretic peptide (145 ± 112 vs 195 ± 153 pg/mL; P = .111), mean left ventricular ejection fraction (62% ± 8% vs 61% ± 9%; P = .624), and type of AF (nonparoxysmal AF 60% vs 62%; P = .852). Amiodarone was continued 40% (14 out of 35) and 40% (20 out of 70) in ABL and CNT groups, respectively (P = 1.000). Neither major complication nor major side effect was observed during the follow‐up period. During a mean follow‐up period of 792 ± 485 days, Kaplan‐Meier curve analysis showed that significantly more patients in the ABL group were free from HF rehospitalization (log‐rank P = .0039). Additionally, multivariate analysis revealed that catheter ablation of AF was the only preventive factor of HF rehospitalization (OR = 0.15; 95% CI: 0.04‐0.46; P < .001). Conclusions Catheter ablation of AF reduced HF rehospitalization compared with conventional pharmacotherapy in patients with HFpEF in our institute. Multicenter randomized study is warranted to confirm the result.

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Section: Predictors Of Hf Rehospitalizationsupporting

confidence: 93%

Section: Predictors Of Hf Rehospitalizationsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Catheter ablation of atrial fibrillation reduces heart failure rehospitalization in patients with heart failure with preserved ejection fraction

Fukui

Tanino

Yamaguchi

et al. 2020

Cardiovasc electrophysiol

View full text Add to dashboard Cite

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“…Atrial fibrillation (AF) is one of the most common arrhythmias in patients with heart failure with preserved ejection fraction (HFpEF) [1][2][3] and each condition predisposes the patient to the other [4]. Patients with AF and concomitant HFpEF suffer from a worse prognosis, including increased mortality [2,3,5,6].…”

Section: Introductionmentioning

confidence: 99%

Impact of stroke volume on prognostic outcome in patients with atrial fibrillation and concomitant heart failure with preserved ejection fraction

Hayashi

Abe

Morita

et al. 2019

Journal of Cardiology

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A B S T R A C TBackground: Atrial fibrillation (AF) can lead to a decrease in stroke volume (SV) despite a preserved left ventricular ejection fraction (LVEF). However, no previous studies have evaluated the prognostic importance of the decreased SV in patients with AF and concomitant heart failure with preserved ejection fraction (HFpEF). Methods: We retrospectively studied the cases of 1520 consecutive patients who had undergone right heart catheterization. HFpEF (New York Heart Association functional class !II and LVEF !50%) was observed in 574 patients. We selected 47 patients with persistent AF with a heart rate of 40-110 bpm and HFpEF without other underlying heart diseases. Results: Among a total of 47 patients, 16 (34%) had normal SV [SV index (SVI) >35 ml/m 2 and 31 (66%) patients had low SV (SVI 35 ml/m 2 )]. During the follow-up period of 1115 AE 305 days, 14 patients (30%) met the composite endpoint defined as cardiac death and admission due to worsening heart failure. Cox proportional hazard ratio analysis showed that SVI was a predictor of the endpoint, independently of the cardiac index and other parameters. Kaplan-Meyer analysis showed that low SVI was significantly associated with a poor prognosis, with an event-free rate of 58% at the mean follow-up period of 991 days (log-rank p = 0.02). In the multiple regression analysis, a high systemic vascular resistance index and a high heart rate were independent determinants of low SVI. Conclusions: Our findings suggest that low SV had a significant impact on prognosis in patients with AF despite the preserved LVEF. The SVI depended on the heart rate and SVRI.

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“…Several recent meta-analyses concluded that CA was superior to drug therapy in improving multiple outcomes, including cardiac function and quality of life in patients with AF and heart failure (HF) [17][18][19][20]. A recent study evaluated the long-term outcomes of CA for AF patients with HF and showed that about 90% of HF patients (irrespective of the type of HF) treated with CA remained free from deaths, strokes, and unplanned HF hospitalizations for 4 years post-CA [21]. Other studies reported that CA was safe and effective for elderly AF patients [22,23].…”

Section: Introductionmentioning

confidence: 99%

Characteristics and anticoagulant treatment status of elderly non-valvular atrial fibrillation patients with a history of catheter ablation in Japan: Subanalysis of the ANAFIE registry

Okumura

Yamashita

Akao

et al. 2020

Journal of Cardiology

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Background: Benefits of catheter ablation (CA) have been shown for patients with atrial fibrillation (AF), including elderly patients. However, data in patients aged !75 years who have undergone CA for nonvalvular AF (NVAF) are lacking. This cross-sectional subanalysis of the ANAFIE registry determined the characteristics and status of anticoagulant treatment in elderly NVAF patients with a history of CA at enrollment. Method: The ANAFIE registry was a multicenter, prospective, non-interventional cohort study in which elderly ambulatory patients (!75 years) diagnosed with NVAF by electrocardiogram were enrolled between October 2016 and January 2018. Treatment was prescribed per routine clinical practice by individual treating physicians. The patients were stratified into two groups: the CA and No-CA groups. Results: Among 32,726 NVAF patients aged !75 years, 3002 (9.2%) underwent CA before enrollment. Patients who underwent CA were significantly younger (78.9 years vs 81.7 years; p < 0.0001), had significantly greater height and body weight, as well as creatinine clearance rate (CCr) compared with those who did not undergo CA. In both the CA and No-CA groups, the most common type of AF was paroxysmal AF (72.9% and 38.9%). In the CA group, a significantly larger proportion of patients did not receive anticoagulant therapy compared with the No-CA group (13.3% vs 7.6%; p < 0.0001). Direct oral anticoagulant (DOAC) use was similar in the CA (69.9%) and No-CA (66.0%) groups, and standard doses of

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Impact of catheter ablation of atrial fibrillation on long-term clinical outcomes in patients with heart failure

Abstract: Catheter ablation of AF could be one of the important therapeutic options in the management of patients with HF combined with AF regardless of the type of HF.

Cited by 44 publications

References 25 publications

Catheter ablation of atrial fibrillation reduces heart failure rehospitalization in patients with heart failure with preserved ejection fraction

Catheter ablation of atrial fibrillation reduces heart failure rehospitalization in patients with heart failure with preserved ejection fraction

Impact of stroke volume on prognostic outcome in patients with atrial fibrillation and concomitant heart failure with preserved ejection fraction

Characteristics and anticoagulant treatment status of elderly non-valvular atrial fibrillation patients with a history of catheter ablation in Japan: Subanalysis of the ANAFIE registry

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