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 .
N-terminal pro-B-type natriuretic peptide level at long-term follow-up after atrial fibrillation ablation: a marker of reverse atrial remodelling and successful ablation
Aims We investigated the relationship between arrhythmia burden , left atrial volume ( LAV ) and N-terminal pro-B-type natriuretic peptide ( NT-pro-BNP ) at baseline and after long-term follow-up of  atrial fibrillation ( AF ) ablation . Methods We studied 38 patients ( 23 paroxysmal , 6 women , mean age 56 ± 11 ) scheduled for AF ablation .  LAV was calculated on the basis of computed tomography images at baseline and long-term follow-up , and arrhythmia burden was grade d from self-reported frequency and duration of AF episodes . Results After a mean period of 22 ± 5 months , 28/38 patients ( 11/15 persistent ) were free from AF recurrence . At baseline there were no differences in mean LAV ( 125 vs. 130 cm3 , p = 0.7 ) or median NT-pro-BNP ( 33.5 vs. 29.5 pmol/L , p = 0.9 ) between patients whose ablation had been successful or otherwise . At long-term follow-up , there was a marked decrease in LAV ( 105 vs. 134 cm3 , p < 0.05 ) and level of NT-pro-BNP ( 7 vs. 17.5 pmol/L , p < 0.05 ) in the successful ablation patients . NT-pro-BNP correlated with LAV both at baseline ( r = 0.71 , p < 0.001 ) and at follow-up ( r = 0.57 , p < 0.001 ) . Arrhythmia burden correlated with both NT-pro-BNP ( r = 0.47 , p < 0.01 ) and LAV ( r = 0.52 , p < 0.01 ) . A decrease in NT-pro-BNP at follow-up of > 25 % of baseline value had a specificity of 0.89 and a sensitivity of 0.6 ( receiver operator characteristics , accuracy 0.82 ) for ablation success . Conclusions NT-pro-BNP correlates with LAV and arrhythmia burden in AF patients and both NT-pro-BNP and LAV decrease significantly after successful ablation . A decrease in NT-pro-BNP of > 25 % from the baseline value could be useful as a marker of ablation success
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 .