Catheter ablation may be an effective therapy in AF patients with left ventricular systolic impairment , and can be associated with improvements in left ventricular function , quality of life , exercise capacity , and modest rates of serious adverse events
INTRODUCTION Catheter ablation of atrial fibrillation ( AF ) is an established rhythm control strategy ; however , the impact of co-existing LV systolic dysfunction ( LVSD ) on ablation success is less well understood .
This systematic review compiles the outcomes of catheter ablation of atrial fibrillation in patients with LVSD .
Sinus rhythm restoration by catheter ablation in patients with long-lasting atrial fibrillation and congestive heart failure: impact of the left ventricular ejection fraction improvement on the implantable cardioverter defibrillator insertion indication.
AIMS In the setting of congestive heart failure ( CHF ) , atrial fibrillation ( AF ) ablation can improve clinical status and the left ventricular ejection fraction ( LVEF ) value . However , the impact of AF ablation on the implantable cardioverter defibrillator ( ICD ) indication has never been specifically addressed . METHODS AND RESULTS Study subject were six CHF ( mean age 61.1 + /- 6.9 years , mean LVEF 25.8 + /- 7.3 % ) patients refractory to conventional medical treatment with long-lasting AF unresponsive to external cardioversion . Five patients had an idiopathic dilated cardiomyopathy ( DCM ) and one had an ischaemic cardiomyopathy ( ICM ) . Their New York Heart Association ( NYHA ) class was III-IV . Two patients had renal insufficiency . No patient had left ventricular delay . All patients underwent AF ablation .  LVEF and NYHA class were dramatically improved in the five DCM patients . New York Heart Association class , but not the LVEF , was improved in the ICM patient . A redo ablative procedure was undertaken in four of five DCM patients and in the ICM patient due to arrhythmia recurrence . Left ventricular ejection fraction and NYHA were improved again in the DCM patients ( 56 + /- 4.4 % , I-II , respectively ) and led to ICD indication preclusion . The LVEF remained low in the ICM patient ( 30 % ) and led to ICD insertion . Sinus rhythm has been stable during the 18.1 + /- 5.7 months follow-up period . CONCLUSION  Atrial fibrillation ablation in CHF patients can improve both the clinical status of patients and their LVEF , especially among those affected by DCM . The LVEF improvement has the potential to preclude the indication for a primary prevention ICD insertion
Catheter ablation may be an effective therapy in AF patients with left ventricular systolic impairment , and can be associated with improvements in left ventricular function , quality of life , exercise capacity , and modest rates of serious adverse events
INTRODUCTION Catheter ablation of atrial fibrillation ( AF ) is an established rhythm control strategy ; however , the impact of co-existing LV systolic dysfunction ( LVSD ) on ablation success is less well understood .
This systematic review compiles the outcomes of catheter ablation of atrial fibrillation in patients with LVSD .