Effect of early catheter ablation of atrial fibrillation in patients with heart failure.
Introduction: According to current guidelines, pulmonary vein isolation as first‐line therapy should be considered for patients with atrial fibrillation (AF), however, optimal timing of the procedure is still unknown in patients with heart failure (HF). We aimed to evaluate the effect of early cathe...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 35; no. 7; pp. 1471 - 1480 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jul2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=178395178&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 178395178 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Jul2024 vid: 35 iid: 7 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 178395178 177477311 178395178 178395178 10.1111/jce.16300 178395178 ppf: 1471 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Effect of early catheter ablation of atrial fibrillation in patients with heart failure. aug: au: Tóth, Patrik Arnóth, Bence Komlósi, Ferenc Szegedi, Nándor Salló, Zoltán Perge, Péter Osztheimer, István Merkely, Béla Gellér, László Nagy, Klaudia Vivien affil: Heart and Vascular Center, Semmelweis University, Budapest, Hungary sug: subj: Catheter Ablation Adverse Effects Catheter Ablation Mortality Atrial Fibrillation Diagnosis Atrial Fibrillation Mortality Atrial Fibrillation Surgery Heart Failure Complications Heart Failure Mortality Ventricular Function, Left Treatment Outcomes Human Female Male Middle Age Aged Retrospective Design Prospective Studies Nonexperimental Studies Atrial Fibrillation Physiopathology Heart Failure Physiopathology Pulmonary Veins Physiopathology Action Potentials Heart Rate Pulmonary Veins Surgery Recurrence Stroke Volume Patient Care Atrial Fibrillation Risk Factors Risk Assessment Comorbidity Cardiac Patients Descriptive Statistics Funding Source Middle Aged: 45-64 years Aged: 65+ years Female Male ab: Introduction: According to current guidelines, pulmonary vein isolation as first‐line therapy should be considered for patients with atrial fibrillation (AF), however, optimal timing of the procedure is still unknown in patients with heart failure (HF). We aimed to evaluate the effect of early catheter ablation (CA) in patients with HF and left ventricular ejection fraction (LVEF) below 50%. Methods: We analyzed data from a structured registry comprising 227 patients with paroxysmal or persistent AF and HF with LVEF < 50% who underwent radiofrequency CA between 2015 and 2022. Early CA was defined as a procedure performed within 12 months of AF diagnosis. The median follow‐up duration was 1748 (1176.3–2353.5) days, with a minimum follow‐up of 365 days. Our endpoints were AF recurrence after a 3‐months blanking period and all‐cause mortality. Results: Among the 227 patients with a median age of 64.3 years, 97 (42.7%) experienced AF recurrence and 55 (24.2%) died during the follow‐up period. The median LVEF was 40% for early CA and 38% for delayed CA (p =.053). Early CA significantly reduced AF recurrence (HR = 0.25 [0.15–0.42], p <.001), however, the timing of procedure did not affect all‐cause mortality (p =.16). These findings were consistent regardless of AF subtype or the burden of comorbidities, as assessed by the CHA2DS2‐VASc score. Conclusion: The timing of CA of AF appears to be an important factor in patients with HF. Early CA reduced AF recurrence, although it does not impact all‐cause mortality. We found similar results regardless of AF subtype or burden of comorbidities. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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