Predictors of Atrial Fibrillation Recurrence After Radiofrequency Ablation in Patients With Chronic Heart Failure

Abstract

The aim: To study the predictive power of demographic, hemodynamic and electrocardiographic factors for atrial fibrillation recurrence after radiofrequency ablation (RFA) in patients with chronic heart failure. Materials and methods: Study included 120 patients, aged 59,80±10,08 years old with chronic heart failure with preserved left ventricular ejection fraction who were undergo RFA due to atrial fibrillation (AF). A standard 12-lead electrocardiogram (ECG) was registered. Before the procedure the standard echocardiographic parameters were obtained. After 12 months, patients were divided into 2 groups: non-recurrence group and recurrence group. Results: As a result of prospective follow-up within 12 months AF recurrences were observed in 32 patients (27%), 88 patients remained non-recurrent (73%). The left atrium (LA) diameter and aortic root diameter were lager in the recurrence group (4,59±0,45 vs. 4,08±0,61 cm, p<0,001; 3,37±0,60 vs. 2,80±0,67 cm, p<0,001). The AF recurrence group before RFA had a significantly longer QTc interval than the non-recurrence group (387,23±2,31 vs. 341,22±8,91 ms, p<0,010). ROC curve analysis revealed LA diameter the most sensitive factor for AF recurrence after RFA. Conclusions: QTc duration before radiofrequency ablation and its prolongation after intervention are independent predictors of atrial fibrillation recurrence; left atrium diameter before ablation is a highly sensitive predictor in patients with chronic heart failure with preserved left ventricular ejection fraction.

Catheter Ablation for Atrial Fibrillation in Patients with Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis

“…The increased afterload caused by aldosterone leads to further myocardial fibrosis, and its levels have been shown to reduce after successful cardioversion of AF [7]. Notably, there are various factors that have been reported to predict mortality and arrhythmia recurrence outcomes in patients with AF, including functional mitral and tricuspid regurgitation [8], reduced left atrial ejection force [9], and QTc duration [10].…”