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Catheter Ablation for Atrial Arrhythmias in Patients With Cardiac Amyloidosis

Nicholas Y Tan1, Yousef Mohsin2, David O Hodge3

  • 1Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota.

Journal of Cardiovascular Electrophysiology
|July 17, 2016
PubMed

Insights

Catheter ablation offers symptomatic relief for cardiac amyloidosis patients with atrial arrhythmias. However, mortality remains high, particularly for light-chain amyloidosis, highlighting the need for further research.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Amyloidosis Research

Background:

  • Cardiac amyloidosis (CA) increases the risk of atrial arrhythmias.
  • The effectiveness and safety of catheter ablation for CA patients require further evaluation.

Purpose of the Study:

  • To assess the efficacy and safety of catheter ablation in patients with cardiac amyloidosis and atrial arrhythmias.
  • To analyze arrhythmia recurrence, symptom improvement, and mortality rates post-ablation.

Main Methods:

  • Retrospective review of 26 cardiac amyloidosis patients with atrial arrhythmias undergoing ablation (1995-2015).
  • Patients were categorized into atrial arrhythmia ablation (CA-A) and AV nodal ablation (CA-AVN) groups.
  • Outcomes included arrhythmia recurrence, NYHA functional class, and mortality.

Main Results:

  • One- and 3-year recurrence-free survival in the CA-A group were 75% and 60%, respectively.
  • Symptomatic improvement (NYHA) was observed in 70% of CA-A patients and 50% of CA-AVN patients at 6 months.
  • Overall mortality was 11 patients, with a higher rate in the CA-AVN group (8 vs. 3).

Conclusions:

  • Catheter ablation provides significant symptomatic relief for cardiac amyloidosis patients with atrial arrhythmias.
  • Mortality remains a critical concern, especially in light-chain amyloidosis, underscoring the importance of managing the underlying disease.
Abstract

Keywords:
AV junctional ablationatrial fibrillationatrial flutteratrial tachycardiacardiac amyloidosiscatheter ablationpacemaker

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