Atrial Fibrillation in Heart Failure Patients with Preserved or Reduced Ejection Fraction. Prognostic significance of Rhythm control strategy with Catheter Ablation

Abstract

The aim of the study is to evaluate the success rate, freedom from AF and complications associated with AF CA in HF patients with preserved or reduced LVEF. The predictors of AF recurrence, the rate of HF hospitalizations and the NYHA functional class after one year of follow-up according to the presence or absence of SR will also be analyzed. Methods Study design and population We conducted a prospective, observational and single-center study. Consecutive patients with a history of AF and signs and symptoms of HF or LVEF less than 45%, who underwent CA between July 2011 and March 2016, were included. The patients were refractory to or

Catheter Ablation for Atrial Fibrillation in Patients with Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis

“…A total of twelve studies meeting the inclusion criteria were identified [14][15][16][17][19][20][21][22][23][24][25][26]. The selection process is illustrated in Figure 1 (PRISMA) and a total population of 17,921 patients with HFpEF who underwent either a rhythm control, including CA, or a rate control strategy, were included.…”

“…These studies were used separately for analysis of rhythm versus rate control outcomes. Moreover, six studies [19,[21][22][23][24][25] included subgroups of patients with HFrEF who underwent CA and compared outcomes with HFpEF group, although we focused our results only on the group of HFpEF.…”

“…The ablation procedures were performed both under conscious sedation and under general anesthesia. Pulmonary vein antrum isolation (PVAI) was performed with a double-lasso technique under the guidance of a 3D mapping system predominantly CARTO 3, Biosense-Webster, USA but also NavX (St Jude Medical, Inc., Minneapolis, MN, USA), EnSite NavX (Abbott Medical, St. Paul, MN, USA) along with Vecchio et al [19] who used Ensite Velocity cardiac mapping system (St. Jude Medical Inc.). Patients underwent circumferential and/or segmental PVI with or without deployment of linear lesions.…”

In-Hospital Mortality Rate and Predictors of 30-Day Readmission in Patients With Heart Failure Exacerbation and Atrial Fibrillation: A Cross-Sectional Study

“…Having AF by itself did not increase the short-term readmission rate for HF. This might be due to advances in the management of AF in terms of ablation techniques, 19) an increase in the use of antiarrhythmics, novel oral anticoagulants, improvements in cardiac resynchronization therapy, and permanent pacemakers. 20) Patients with both HF and AF are likely to have well-established outpatient care, given the complexity of management which might help prevent short-term readmissions.…”

Safety, Efficacy and Prognostic Benefit of Atrial Fibrillation Ablation in Heart Failure with Preserved Ejection Fraction

“…A growing body of observational data comparing HFpEF to HFrEF and/or to no HF indicates acceptable safety and efficacy profiles of catheter ablation of AF in HFpEF, that seem to mirror findings from HFrEF cohorts. [48][49][50][51][52][53][54][55][56][57] For example, in a single-centre observational retrospective cohort study, Aldaas et al analysed 547 patients who underwent de novo catheter ablation of AF, of whom 51 had HFpEF, 40 had HFrEF and 456 had no HF. 50 HFpEF patients were more often female compared to HFrEF, exhibited a higher prevalence of hypertension and end-stage renal disease compared to no HF and a higher prevalence of OSA and COPD compared to both HFrEF and no HF.…”