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Efficacy and feasibility of cryoballoon ablation for atrial fibrillation in patients with heart failure: A large‐scale multicenter study.

Introduction: Data are limited regarding outcomes of cryoballoon ablation for atrial fibrillation (AF) in patients with heart failure (HF). This large‐scale multicenter study aimed to evaluate the prognosis of patients with HF after cryoballoon ablation for AF. Methods: Among 3655 patients undergoin...

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Published in:Journal of Cardiovascular Electrophysiology Vol. 33; no. 12; pp. 2447 - 2465
Main Authors: Yanagisawa, Satoshi, Suzuki, Hirohiko, Kanzaki, Yasunori, Ishikawa, Shinji, Kamikubo, Yosuke, Okumura, Satoshi, Kato, Hiroyuki, Mizutani, Yoshiaki, Murase, Yosuke, Nakasuka, Kosuke, Warita, Shunichiro, Sekimoto, Satoru, Takemoto, Yoshio, Takasugi, Nobuhiro, Ohguchi, Shiou, Senga, Michiharu, Yokoi, Kenichiro, Shibata, Rei, Inden, Yasuya, Murohara, Toyoaki
Format: research tables/charts Journal Article
Published: Wiley-Blackwell Dec2022
Online Access:View this record in EBSCOhost
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      dt: Dec2022
      vid: 33
      iid: 12
      pid: 480
      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/jce.15691
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      tig:
        atl: Efficacy and feasibility of cryoballoon ablation for atrial fibrillation in patients with heart failure: A large‐scale multicenter study.
      aug:
        au:
          Yanagisawa, Satoshi
          Suzuki, Hirohiko
          Kanzaki, Yasunori
          Ishikawa, Shinji
          Kamikubo, Yosuke
          Okumura, Satoshi
          Kato, Hiroyuki
          Mizutani, Yoshiaki
          Murase, Yosuke
          Nakasuka, Kosuke
          Warita, Shunichiro
          Sekimoto, Satoru
          Takemoto, Yoshio
          Takasugi, Nobuhiro
          Ohguchi, Shiou
          Senga, Michiharu
          Yokoi, Kenichiro
          Shibata, Rei
          Inden, Yasuya
          Murohara, Toyoaki
        affil: Department of Advanced Cardiovascular Therapeutics, Nagoya University Graduate School of Medicine, Nagoya, Japan
      sug:
        subj:
          Atrial Fibrillation Surgery
          Heart Failure Prognosis
          Catheter Ablation
          Human
          Multicenter Studies
          Retrospective Design
          Recurrence
          Cause of Death
          Ventricular Ejection Fraction
          Echocardiography
          Natriuretic Peptide, Brain Blood
          Heart Physiology
          Postoperative Complications
          Multivariate Analysis
          Myocardial Diseases
          Japan
      ab: Introduction: Data are limited regarding outcomes of cryoballoon ablation for atrial fibrillation (AF) in patients with heart failure (HF). This large‐scale multicenter study aimed to evaluate the prognosis of patients with HF after cryoballoon ablation for AF. Methods: Among 3655 patients undergoing cryoballoon ablation at 17 institutions, 549 patients (15%) (391 with paroxysmal AF and 158 with persistent AF) diagnosed with HF preoperatively were analyzed. Clinical endpoints were recurrence, mortality, and HF hospitalization after ablation. Results: Most patients had a preserved left ventricular ejection fraction (LVEF) ≥ 50%. During a mean follow‐up period of 25.7 months, recurrence, all‐cause death, and HF hospitalization occurred in 29%, 4.0%, and 4.8%, respectively. Cardiac function on echocardiography and B‐type natriuretic peptide (BNP) levels significantly improved postoperatively, and the effect was more pronounced in the nonrecurrence group. Major complications occurred in 33 patients (6.0%), but most complications were phrenic nerve palsy (3.6%). Although death and HF hospitalization occurred more frequently in patients with LVEF ≤ 40% (n = 73) and New York Heart Association (NYHA) class III–IV (n = 19) than other subgroups, the BNP levels, and LVEF significantly improved after ablation in all LVEF and NYHA class subgroups. High BNP levels, NHYA class, CHADS2 score, and structural heart disease, but not postablation recurrence, independently predicted death, and HF hospitalization on multivariate analysis. The patients with tachycardia‐induced cardiomyopathy had better recovery of BNP levels and LVEF after ablation than those with structural heart disease. Conclusions: Cryoballoon ablation for AF in HF patients is feasible and leads to significantly improved cardiac function.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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