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 .
Success of Ablation for Atrial Fibrillation in Isolated Left Ventricular Diastolic Dysfunction: A Comparison to Systolic Dysfunction and Normal Ventricular Function
Background — The efficacy of radiofrequency ablation for atrial fibrillation ( AF ) in patients with left ventricular ( LV ) systolic dysfunction and isolated diastolic dysfunction is uncertain . Methods and Results — A prospect i ve cohort of patients with normal and abnormal LV function underwent ablation for antiarrhythmic drug (AAD)-refractory AF . Three groups were compared : 111 patients with systolic dysfunction , defined as LV ejection fraction ( LVEF ) ⩽40 % ; 157 patients with isolated diastolic dysfunction but preserved LVEF ≥50 % ; and 100 patients with normal LV function . The primary end point was AAD-free AF elimination at 1 year after ablation . This end point was achieved in 62 % of patients with systolic dysfunction , 75 % of those with diastolic dysfunction , and 84 % of controls ( P=0.007 ) . AF control on or off AADs was achieved in 76 % of patients with systolic dysfunction , 85 % of those with diastolic dysfunction , and 89 % of controls ( P=0.08 ) . In the systolic dysfunction group , 49 % experienced an increase in LVEF by ≥5 % after ablation , of which 64 % achieved normal LVEF . In the diastolic dysfunction group , 30 % of patients demonstrated at least 1 grade improvement in diastolic dysfunction . Multivariable analysis demonstrated an increased relative risk of arrhythmia recurrence of 1.8 ( 95 % CI , 1.1 to 3.1 ; P=0.02 ) in systolic dysfunction and 1.7 ( 1.0 to 2.7 ; P=0.04 ) in isolated diastolic dysfunction compared with normal function . Conclusions — Although an ablative approach for AF in patients with systolic or diastolic dysfunction is associated with an increased long-term recurrence risk , there is potential for substantial quality -of-life improvement and LV functional benefit
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 .