Prognostic Significance of Post-Procedural Left Ventricular Ejection Fraction Following Atrial Fibrillation Ablation in Patients With Systolic Dysfunction

Abstract

Study Population This retrospective observational study screened 1,077 consecutive patients undergoing radiofrequency catheter ablation for AF (Figure 1). Of patients undergoing circumferential pulmonary vein isolation (PVI) between August 2009 and May 2019, 195 who had impaired LVEF (<50%) were enrolled in the present study. Patients who underwent cardiac resynchronized therapy after the procedure, those who were followed up for <6 months after the procedure, and those who did not receive echocardiographic evaluations 3 months after the index procedure were excluded. AF ablation was indicated based on previous expert consensus statements. 7-9 Within the 1 month prior to each session, patients underwent 3-dimensional cardiac computed A trial fibrillation (AF) is often associated with impaired left ventricular ejection fraction (LVEF) and poor prognosis due to the absence of atrioventricular synchrony, a deficiency of atrial kick, irregularity, or tachycardia. 1 Several randomized control studies have reported that AF ablation is associated with a good prognosis and significant LVEF improvement. 2,3 In addition, several studies have reported predictors of LVEF improvement after AF ablation in heart failure patients. 4-6 Nevertheless, the definition of LVEF improvement varies among studies, meaning that the relationship between LVEF improvement and prognosis is not clear. Therefore, the aim of the present study was to investigate the relationship between post-procedural LVEF (3 months after the procedure) and prognosis in patients who underwent AF ablation.

Catheter Ablation for Atrial Fibrillation Targeting Incremental Left Ventricular Ejection Fraction

“…2 In the study of Yazaki et al, some patients underwent multiple catheter ablations to treat recurrent atrial tachyarrhythmia. 3 The next concern is whether such interventions could also ameliorate cardiac function, as well as clinical outcomes, following recovery to sinus rhythm.…”

“…2 Yazaki et al demonstrated that an incremental improvement in left ventricular ejection fraction (LVEF) following catheter ablation for AF was associated with a greater clinical outcome compared with persistently impaired cardiac function. 3 Yazaki et al stratified clinical outcomes by post-procedural LVEF status. 3 Post-procedural clinical outcomes stratified by improvement in cardiac function vs. remaining cardiac function would be of great interest.…”

“…3 Yazaki et al stratified clinical outcomes by post-procedural LVEF status. 3 Post-procedural clinical outcomes stratified by improvement in cardiac function vs. remaining cardiac function would be of great interest. Following catheter ablation, a recurrence of atrial tachyarrhythmia was associated with persistently impaired cardiac function.…”

“… 2 Yazaki et al demonstrated that an incremental improvement in left ventricular ejection fraction (LVEF) following catheter ablation for AF was associated with a greater clinical outcome compared with persistently impaired cardiac function. 3 …”

“…Following catheter ablation, a recurrence of atrial tachyarrhythmia was associated with persistently impaired cardiac function. 3 Analyses to investigate any other risk factors for persistently reduced ejection fraction would help clinicians with risk stratification and optimal patient selection. For example, shorter HF duration and non-ischemic etiology with reduced myocardial scar may be key to improved cardiac function following catheter ablation.…”