AFCA efficacy in patients with impaired left ventricular systolic function improves when performed early in the natural history of atrial fibrillation and heart failure .
AFCA provides long-term benefits on left ventricular function , significantly reducing the number of patients with severely impaired systolic function
BACKGROUND Catheter ablation of atrial fibrillation ( AFCA ) is an established therapeutic option for rhythm control in symptomatic patients .
Its efficacy and safety among patients with left ventricular systolic dysfunction is based on small population s , and data concerning long-term outcome are limited .
We performed this meta- analysis to assess safety and long-term outcome of AFCA in patients with left ventricular systolic dysfunction , to evaluate predictors of recurrence and impact on left ventricular function .
Clinical outcomes of catheter substrate ablation for high-risk patients with atrial fibrillation.
OBJECTIVES The purpose of this study was to determine the long-term clinical outcomes of catheter ablation of atrial fibrillation ( AF ) substrate for high-risk patients with AF . BACKGROUND The benefits of catheter ablation for high-risk AF patients with respect to mortality and stroke reductions remain unclear . METHODS We performed AF substrate ablation guided by complex fractionated atrial electrogram ( CFAE ) mapping in 674 high-risk AF patients . The clinical end points were sinus rhythm ( SR ) , death , stroke , or bleeding .  Of these 674 patients , 635 were available for follow-up and made up the study cohort . The patients were relatively old ( mean age 67 + /- 12 years ) and 129 had an ejection fraction ( EF ) < 40 % . RESULTS After the mean follow-up period of 836 + /- 605 days , 517 were in SR ( 81.4 % ) . There were 15 deaths among the patients who stayed in SR compared with 14 deaths among those who remained in AF ( 5-year survival rate , 92 % vs. 64 % , respectively ; p < 0.0001 ) . SR was the most important independent favorable parameter for survival ( hazard ratio 0.14 , 95 % confidence interval 0.06 to 0.36 , p < 0.0001 ) , whereas old age was unfavorable . Warfarin therapy was discontinued in 434 of the 517 patients in SR post-ablation ( 84 % ) whose annual stroke rate was only 0.4 % compared with 2 % in those with continuing warfarin treatment ( p = 0.004 ) . CONCLUSIONS CFAE-targeted ablation of AF is effective in maintaining SR in selected high-risk AF patients and might allow patients to stop warfarin therapy . SR after AF ablation is a marker of relatively low mortality and stroke risk . Our findings support conducting further r and omized studies to determine whether AF ablation is associated with mortality and /or stroke reduction
AFCA efficacy in patients with impaired left ventricular systolic function improves when performed early in the natural history of atrial fibrillation and heart failure .
AFCA provides long-term benefits on left ventricular function , significantly reducing the number of patients with severely impaired systolic function
BACKGROUND Catheter ablation of atrial fibrillation ( AFCA ) is an established therapeutic option for rhythm control in symptomatic patients .
Its efficacy and safety among patients with left ventricular systolic dysfunction is based on small population s , and data concerning long-term outcome are limited .
We performed this meta- analysis to assess safety and long-term outcome of AFCA in patients with left ventricular systolic dysfunction , to evaluate predictors of recurrence and impact on left ventricular function .