Related Experiment Video
Updated: Apr 1, 2026
10:46
Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
Published on: May 26, 2015
13.9K
Optimal Ablation Strategies for Persistent Atrial Fibrillation With Heart Failure: Three-Year Follow-Up of a
Kaige Li1, Xinhua Wang2, Mu Qin1
1Department of Cardiology, Shanghai Jiao Tong University School of Medicine, Shanghai Chest Hospital, China (K.L., M.Q., W.J., Y.Z., S.W., K.X., X.L., X.H.).
Circulation. Arrhythmia and Electrophysiology
|March 31, 2026
Summary
Extensive electrogram-anatomic ablation significantly improved outcomes for heart failure patients with atrial fibrillation. This strategy reduced cardiovascular events and maintained sinus rhythm better than other ablation methods.
Area of Science:
- Cardiology
- Electrophysiology
- Heart Failure Management
Background:
- Catheter ablation improves prognosis in heart failure (HF) and atrial fibrillation (AF) patients.
- Optimal ablation strategy for persistent AF and HF remains undefined.
Purpose of the Study:
- To compare the effectiveness of different catheter ablation strategies in patients with persistent AF and HF.
- To evaluate the impact of ablation strategy on cardiovascular events and rhythm control.
Main Methods:
- A multicenter randomized controlled trial involving 300 patients with persistent AF and HF.
- Patients were randomized to anatomic-guided, electrogram-guided, or extensive electrogram-anatomic-guided ablation.
- Coprimary end points included cardiovascular death/HF hospitalization and sinus rhythm maintenance at 36 months.
Main Results:
- The extensive electrogram-anatomic-guided ablation group showed the lowest composite end point incidence (17.0%) and highest sinus rhythm maintenance rate (62.0%) at 36 months.
- Significant improvements were noted in AF burden, NYHA class, 6-minute walk test, and NT-proBNP across groups.
- Trends were consistent in both HF with reduced and preserved ejection fraction subgroups, with low complication rates.
Conclusions:
- Electrogram-anatomic ablation offers superior long-term rhythm control and reduces cardiovascular events in persistent AF and HF patients.
- This strategy improves symptoms regardless of ejection fraction status.
- The findings support extensive electrogram-anatomic-guided ablation as an optimal strategy for this patient population.
Related Concept Videos
01:22Heart Failure VI: Adjunct Therapies
580
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
580
01:30Heart Failure V: Medical Management
532
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
532
01:25Dysrhythmias VI: Management of Dysrhythmias
615
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
615
01:29Disturbances in Heart Rhythm
3.8K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
3.8K
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
983
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
983
01:29Cardiomyopathy V: Interprofessional Care
641
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
641