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Five-year outcomes of catheter ablation in patients with atrial fibrillation and left ventricular systolic dysfunction.
- Source :
-
Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2015 Apr; Vol. 26 (4), pp. 363-370. Date of Electronic Publication: 2015 Feb 11. - Publication Year :
- 2015
-
Abstract
- Background: Catheter ablation of atrial fibrillation (AF) is an established therapy for symptomatic patients. The long-term efficacy and impact of catheter ablation among patients with severe systolic heart failure (SHF) requires additional study to understand if outcomes achieved at 1 year are maintained and mechanisms of AF recurrence.<br />Methods: Three groups with SHF and 5 years of follow-up were matched 1:4:4 by age (±5 years) and sex: AF ablation patients receiving their first ablation (n = 267), AF patients that did not receive an ablation (n = 1,068), and SHF patient without AF (n = 1,068). SHF was based upon clinical diagnosis and an ejection fraction (EF) ≤35%. Patients were followed for 5-year primary outcomes of AF recurrence, heart failure, stroke, death, and cardiac function.<br />Results: At 5 years, 60.7% of patients had clinical recurrence of AF. Diabetes and a prior heart attack were significant predictors of long-term risk of AF recurrence. Long-term mortality rates were 27%, 55%, 50%, in the AF ablation, AF, and no AF groups, respectively (P < 0.0001), with the lower rates attributed to lower cardiovascular mortality. At 5 years, there was no difference in EF, yet HF hospitalizations were lower following AF ablation compared to patients with AF and no ablation. Stroke rates at 5 years trended to be lower in the AF ablation group, but the difference was not statistically significant.<br />Conclusion: Recurrence rates of AF in patients with SHF after ablation are common at 5 years with an anticipated ongoing increase. Long-term AF-related comorbidities tended to be less in the AF ablation group.<br /> (© 2014 Wiley Periodicals, Inc.)
- Subjects :
- Aged
Aged, 80 and over
Atrial Fibrillation diagnosis
Atrial Fibrillation mortality
Atrial Fibrillation physiopathology
Comorbidity
Disease Progression
Female
Heart Failure mortality
Heart Failure physiopathology
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Recovery of Function
Recurrence
Retrospective Studies
Risk Factors
Stroke mortality
Stroke physiopathology
Stroke Volume
Time Factors
Treatment Outcome
Utah epidemiology
Ventricular Dysfunction, Left diagnosis
Ventricular Dysfunction, Left mortality
Ventricular Dysfunction, Left physiopathology
Atrial Fibrillation surgery
Catheter Ablation adverse effects
Catheter Ablation mortality
Systole
Ventricular Dysfunction, Left epidemiology
Ventricular Function, Left
Subjects
Details
- Language :
- English
- ISSN :
- 1540-8167
- Volume :
- 26
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of cardiovascular electrophysiology
- Publication Type :
- Academic Journal
- Accession number :
- 25534572
- Full Text :
- https://doi.org/10.1111/jce.12602