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 .
Mortality, morbidity, and quality of life after circumferential pulmonary vein ablation for atrial fibrillation: outcomes from a controlled nonrandomized long-term study.
OBJECTIVES This study was design ed to investigate the potential of circumferential pulmonary vein ( PV ) ablation for atrial fibrillation ( AF ) to maintain sinus rhythm ( SR ) over time , thus reducing mortality and morbidity while enhancing quality of life ( QoL ) . BACKGROUND Circumferential PV ablation is safe and effective , but the long-term outcomes and its impact on QoL have not been assessed or compared with those for medical therapy . METHODS We examined the clinical course of 1,171 consecutive patients with symptomatic AF who were referred to us between January 1998 and March 2001 . The 589 ablated patients were compared with the 582 who received antiarrhythmic medications for SR control . The QoL of 109 ablated and 102 medically treated patients was measured with the SF-36 survey . RESULTS Median follow-up was 900 days ( range 161 to 1,508 days ) . Kaplan-Meier analysis showed observed survival for ablated patients was longer than among patients treated medically ( p < 0.001 ) , and not different from that expected for healthy persons of the same gender and calendar year of birth ( p = 0.55 ) . Cox proportional-hazards model revealed in the ablation group hazard ratios of 0.46 ( 95 % confidence interval [ CI ] , 0.31 to 0.68 ; p < 0.001 ) for all-cause mortality , of 0.45 ( 95 % CI , 0.31 to 0.64 ; p < 0.001 ) for morbidities mainly due to heart failure and ischemic cerebrovascular events , and of 0.30 ( 95 % CI , 0.24 to 0.37 ; p < 0.001 ) for AF recurrence . Ablated patients ' QoL , different from patients treated medically , reached normative levels at six months and remained unchanged at one year . CONCLUSIONS Pulmonary vein ablation improves mortality , morbidity , and QoL as compared with medical therapy . Our findings pave the way for r and omized trials to prospect a wider application of ablation therapy for AF
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 .