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Robotic Ablation of Atrial Fibrillation
11:21

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Procedural Outcomes of Patients With Heart Failure Undergoing Catheter Ablation of Atrial Fibrillation

Manju Bengaluru Jayanna1,2,3, Ala Mohsen1,2, Chakradhari Inampudi1

  • 1Division of Cardiovascular Diseases, Section of Heart Failure and Transplant, University of Iowa Hospitals and Clinics, Iowa City, IA.

American Journal of Therapeutics
|March 21, 2019
PubMed

Insights

Catheter ablation for atrial fibrillation (AF) in heart failure (HF) patients shows similar recurrence rates after risk factor adjustment. However, HF predicts higher AF recurrence in paroxysmal AF cases.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • Atrial fibrillation (AF) and heart failure (HF) often coexist due to shared risk factors.
  • Catheter ablation is a common treatment for AF rhythm control.

Purpose of the Study:

  • To identify characteristics and procedural outcomes of patients with HF undergoing AF catheter ablation.
  • To compare AF recurrence rates between patients with and without HF post-ablation.

Main Methods:

  • Retrospective cohort study of 264 AF patients undergoing catheter ablation.
  • Analysis of 73 patients (28%) with known stage C HF (reduced or preserved ejection fraction).
  • Comparison of procedural outcomes, focusing on AF recurrence rates at 3 months and 1 year.

Main Results:

  • Patients with HF had higher unadjusted AF recurrence rates at 3 months and 1 year.
  • After logistic regression adjusting for left atrial size, AF type, and CHA2DS2-VASc score, no significant difference in recurrence was observed.
  • HF predicted higher recurrence in paroxysmal AF patients, with no difference between HF with reduced or preserved ejection fraction.
  • Longer procedure length in HF patients, but no increased periprocedural complications.

Conclusions:

  • While HF patients have more recurrence risk factors, adjusted AF recurrence rates post-ablation are similar to non-HF patients.
  • Heart failure is a predictor of higher AF recurrence in the subset of patients with paroxysmal AF.
Abstract

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