Surgical Ablation of Atrial Fibrillation in Patients With Congestive Heart Failure

Grubitzsch, Herko; Dushe, Simon; Beholz, Sven; Dohmen, Pascal M.; Konertz, Wolfgang

doi:10.1016/j.cardfail.2007.04.011

Cited by 14 publications

(14 citation statements)

References 28 publications

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“…In an on‐treatment analysis of the AFFIRM study, sinus rhythm was also associated with mortality reduction . Restoration and maintenance of sinus rhythm for 3 months resulted in improved systolic function and long‐term prognosis . Similar effects of sinus rhythm on left ventricular ejection fraction and decrease in left atrial size was observed in a subanalysis of the RACE trial .…”

Section: Discussionsupporting

confidence: 64%

How much atrial fibrillation causes symptoms of heart failure?

Guglin

Chen

2013

Int J Clin Pract

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Introduction: Patients with atrial fibrillation (AF) are more symptomatic than patients with sinus rhythm. However, it is unknown what per cent of time spent in AF is associated with symptoms. Methods: We used a limited access dataset from the Atrial Fibrillation Follow-up Investigation of Rhythm Management trial. Patients had their current rhythm and New York Heart Association (NYHA) class recorded at baseline and at every follow-up visit. The ratio of number of visits when patients were in AF to the total number of visits was used as a surrogate measure of AF burden. The median number of visits was 12 per patient. We grouped patients labelled as class 0 and I by NYHA as having no symptoms and NYHA II or III as having symptoms. Furthermore, we calculated mortality and the prevalence of symptoms depending on the per cent of visits when they had AF. Results: Of 4060 patients enrolled in the trial, 74 had no follow-up visits and were excluded; the remaining 3986 patients were analysed. Patients who had no or little AF throughout the study (0-20%) had the lowest prevalence of symptoms. Prevalence of symptoms increased with greater per cent of time spent in AF. Specifically, symptoms became more prevalent when AF burden reached 20-40%. Mortality was similar regardless of proportion of visits when patients were in AF. Conclusions: Higher AF burden is associated with higher prevalence of symptoms. The increment became significant when patients were in AF at 20-40% of visits. What's known• Atrial fibrillation (AF) is associated with more symptoms and poorer exercise tolerance than sinus rhythm.• Many symptoms of AF are related to heart failure (HF). What's new• It is unknown how much time does the patient need to be in AF to start experiencing symptoms of HF.• We demonstrated, for the first time, that symptomatic deterioration in AF starts with 20-40% of time spent in AF.

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Section: Discussionsupporting

confidence: 64%

How much atrial fibrillation causes symptoms of heart failure?

Guglin

Chen

2013

Int J Clin Pract

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“…In this and other studies [19,20], a beneficial effect of SR conversion on functional status could be demonstrated. This probably results from restored atrial transport function in the majority of patients with SR, as the left ventricular function was comparable to that of patients developing recurrent AF.…”

Section: Discussionmentioning

confidence: 59%

Factors predicting the time until atrial fibrillation recurrence after concomitant left atrial ablation

Grubitzsch

Grabow

Orawa

et al. 2008

European Journal of Cardio-Thoracic Surgery

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“…From a total of 222 studies found through a PubMed search, 9 were selected for inclusion in the systematic review. 10,24,33,39,[43][44][45][46][47] These included 4 randomized control trial (RCT) studies, 2 non-RCT studies, and 3 studies with no control group. All studies examined HRQL, and 4 of the studies also investigated symptom status.…”

Section: Methods Of Reviewmentioning

confidence: 99%

“…Ad and colleagues found significant improvement from preoperatively to 1 year postoperatively in SF-12 PCS and MCS, 43 whereas Bakker and colleagues 44 found no significant difference between their study sample and the general population normal values in any of the SF-36 subscales at follow-up after surgery. The study by Grubitzsch and colleagues 46 examined HRQL differently using the Minnesota Living with Heart Failure Questionnaire and comparisons by congestive heart failure and rhythm status after surgery. Patients with severe congestive heart failure who regained sinus rhythm after surgery had lower Minnesota Living with Heart Failure total score and Minnesota Living with Heart Failure physical component score compared with patients who did not regain sinus rhythm, but no effect of rhythm status was found for patients with moderate congestive heart failure.…”

Section: Research Question 2a: Does Concomitant Surgical Abla-mentioning

confidence: 99%