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Updated: Jul 4, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Catheter ablation in patients with atrial fibrillation and dilated cardiomyopathy
Yoon-Kee Siow1,2, Chin-Yu Lin1,3, Fa-Po Chung1,3
1Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan.
Insights
Catheter ablation offers long-term atrial fibrillation control in dilated cardiomyopathy patients, improving survival and heart function compared to medication alone. Left atrial diameter predicts recurrence after ablation.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Catheter ablation is effective for atrial fibrillation (AF).
- Long-term outcomes of AF catheter ablation in dilated cardiomyopathy (DCM) are understudied.
Purpose of the Study:
- Assess electrophysiological characteristics in AF patients with DCM.
- Compare long-term clinical outcomes of catheter ablation versus medical therapy for AF in DCM.
Main Methods:
- Examined baseline characteristics and electrophysiological parameters.
- Identified predictors of AF recurrence post-ablation.
- Used propensity score matching to compare outcomes of ablation and medical therapy.
Main Results:
- 343 patients (46 ablation, 297 medical therapy).
- AF recurrence rate was 30.4% after 7.7 years; left atrial diameter predicted recurrence.
- Catheter ablation showed superior overall survival, reduced heart failure hospitalizations, and improved cardiac remodeling compared to medical therapy.
Conclusions:
- Catheter ablation provides effective long-term AF control in DCM patients.
- Ablation improves morbidity and mortality outcomes beyond standard heart failure care.
- Catheter ablation reverses structural cardiac remodeling in DCM patients with AF.
Introduction:
Catheter ablation is an effective and safe strategy for treating atrial fibrillation patients. Nevertheless, studies on the long-term outcomes of catheter ablation in patients with dilated cardiomyopathy are limited. This study aimed to assess the electrophysiological characteristics of atrial fibrillation patients with dilated cardiomyopathy and compare the long-term clinical outcomes between patients undergoing catheter ablation and medical therapy.
Method:
Patient baseline characteristics and electrophysiological parameters were examined to identify the predictors of atrial fibrillation recurrence following catheter ablation. The clinical outcomes of catheter ablation and medical therapy were compared using the propensity score matched method.
Results:
A total of 343 patients were enrolled, with 46 in the catheter ablation group and 297 in the medical therapy group. Among the catheter ablation group, 58.7% (n = 27) had persistent atrial fibrillation. The recurrence rate of atrial arrhythmia was 30.4% (n = 14) after an average follow-up duration of 7.7 years following catheter ablation. The only predictive factor for atrial fibrillation recurrence after catheter ablation was the left atrial diameter. When compared to medical therapy, catheter ablation demonstrated significantly better outcomes in terms of overall survival, freedom from heart failure hospitalization, improvement in left ventricular ejection fraction, and a greater reduction in left ventricular diameter and left atrial diameter after propensity score matching.
Conclusions:
Therefore, catheter ablation proves to be effective in providing long-term control of atrial fibrillation in patients with dilated cardiomyopathy. In addition to standard heart failure care, catheter ablation significantly enhanced both morbidity and mortality outcomes and reversed structural remodeling when compared to heart failure medication alone.
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