Predictors of arrhythmia recurrence in patients with heart failure undergoing left atrial ablation for atrial fibrillation

Clin Cardiol. 2018 Jan;41(1):63-67. doi: 10.1002/clc.22850. Epub 2018 Jan 22.

Abstract

Background: Atrial fibrillation (AF) ablation is increasingly used in patients with reduced left ventricular ejection fraction (LVEF). The aim of the present study was to evaluate the long-term results of a single radiofrequency catheter ablation procedure in heart failure (HF) patients with AF.

Hypothesis: We tested the hypothesis that left atrial ablation is an effective therapeutic modality in patients with heart failure.

Methods: Our study included HF patients with LVEF <50% who underwent catheter ablation for AF at our department between January 2010 and March 2017. All patients underwent our institution's protocol for follow-up post-ablation.

Results: The study enrolled a total of 38 patients (mean age, 54.1 ± 12.2 years; 28 [73.7%] males; mean LVEF, 38.2% ± 6.3%). After a mean follow-up period of 38.2 months (range, 5-92 months), 28 patients (73.7%) were free from arrhythmia recurrence. In multivariate analysis, early arrhythmia recurrence (P = 0.03) and amiodarone antiarrhythmic drug administration (P = 0.003) remained independent predictors of arrhythmia recurrence.

Conclusions: The main findings of this study are that (1) a single radiofrequency catheter ablation procedure is an effective and safe modality for AF in patients with concomitant HF; (2) after a mean 3.3 years of follow-up, 73.7% of HF patients remained in sinus rhythm; and (3) early arrhythmia recurrence was a significant predictor of arrhythmia recurrence after the blanking period.

Keywords: Atrial Fibrillation; Catheter Ablation; Heart Failure.

MeSH terms

  • Atrial Fibrillation / epidemiology
  • Atrial Fibrillation / etiology*
  • Atrial Fibrillation / surgery
  • Catheter Ablation / methods*
  • Electrocardiography, Ambulatory
  • Female
  • Follow-Up Studies
  • Greece / epidemiology
  • Heart Conduction System / physiopathology
  • Heart Conduction System / surgery*
  • Heart Failure / complications*
  • Heart Failure / epidemiology
  • Heart Failure / surgery
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prognosis
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Stroke Volume / physiology*
  • Ventricular Function, Left / physiology*