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Heart Rate Decrease After Atrial Fibrillation Catheter Ablation Predicts Decompensated Heart Failure After the
Yasuhiro Matsuda1, Masaharu Masuda1, Takashige Sakio1
1Kansai Rosai Hospital Cardiovascular Center Amagasaki Japan.
Insights
A decrease in heart rate after atrial fibrillation (AF) ablation is linked to decompensated heart failure (DHF). This finding highlights a key predictor for DHF in AF patients post-catheter ablation.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Decompensated heart failure (DHF) is a known complication of catheter ablation for atrial fibrillation (AF).
- Understanding predictors of DHF is crucial for patient management post-ablation.
Purpose of the Study:
- To investigate the association between heart rate changes and the occurrence of DHF in patients undergoing AF catheter ablation.
- To identify heart rate dynamics as a potential predictor for DHF following AF ablation procedures.
Main Methods:
- A cohort of 1,004 consecutive patients undergoing initial AF ablation was studied.
- Heart rate was monitored before and after the ablation procedure.
- DHF was defined as heart failure requiring medical therapy within 48 hours post-procedure.
Main Results:
- The incidence of DHF was 2% (22 patients).
- Patients who developed DHF had a significantly greater decrease in heart rate post-ablation compared to those who did not (-21±29 vs. 2±21 beats/min; P=0.001).
- A greater post-ablation heart rate decrease was an independent predictor of DHF (HR 0.8; P=0.004).
Conclusions:
- Post-ablation heart rate reduction is an independent predictor of DHF in AF patients.
- Monitoring heart rate changes after AF ablation may help identify patients at risk for DHF.
Abstract:
Decompensated heart failure (DHF) can complicate catheter ablation for atrial fibrillation (AF). We investigated the association between heart rate and DHF in AF patients undergoing catheter ablation. In all, 1,004 consecutive patients who underwent initial ablation for AF (mean [±SD] age 68±10 years; 34% female; persistent AF n=513 [51%]) were enrolled in the study. Heart rate was assessed before and after ablation. DHF was defined as heart failure requiring medical therapy within 2 days after the procedure. The incidence of DHF was 2% (22 of 1,004 patients). Patients with DHF had a higher prevalence of a history of symptomatic heart failure (11/22 [50%] vs. 160/982 [16%]; P<0.0001) and a greater degree of heart rate decrease after the procedure (-21±29 vs. 2±21 beats/min; P=0.001) than those without DHF. On multivariate analysis, heart rate decrease was a significant independent predictor of DHF (hazard ratio 0.8; 95% confidence interval 0.7-0.9; P=0.004; 10 beats/min-increment). In patients undergoing AF ablation, a decrease in heart rate after the procedure was an independent predictor of DHF.
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