Meta-Analysis of the Effectiveness and Safety of Catheter Ablation of Atrial Fibrillation in Patients With Versus Without Left Ventricular Systolic Dysfunction

Wilton, Stephen B.; Fundytus, Adam; Ghali, William A.; Veenhuyzen, George D.; Quinn, F. Russell; Mitchell, L. Brent; Hill, Michael D.; Faris, Peter; Exner, Derek V.

doi:10.1016/j.amjcard.2010.06.053

Cited by 101 publications

(64 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[102] However, in two Clearly, CA is rapidly evolving at present, and improvements in the efficacy and safety of this procedure occur frequently. [113] Numerous studies have demonstrated the superiority of CA over medical therapy in maintaining NSR in structurally normal hearts. The initial experience suggests that these advantages may also extend to patients with HFhowever at this time the number of randomized studies remains small.…”

Section: Accepted M Manuscriptmentioning

confidence: 99%

Atrial Fibrillation and Heart Failure: Update 2015

Thihalolipavan

Morin

2015

Progress in Cardiovascular Diseases

View full text Add to dashboard Cite

Section: Accepted M Manuscriptmentioning

confidence: 99%

Atrial Fibrillation and Heart Failure: Update 2015

Thihalolipavan

Morin

2015

Progress in Cardiovascular Diseases

View full text Add to dashboard Cite

“…Despite no difference between groups at baseline, 36-item Short-Form scores were higher (meaning better quality of life) for several parameters in the catheter ablation group at 6 months. There was a significant difference between groups for physical functioning (71.0%; CI, 60.5%-81.5% in the ablation group versus 49.1%; CI, 36 …”

Section: Effect On Symptoms and Quality Of Lifementioning

confidence: 99%

A Randomized Controlled Trial of Catheter Ablation Versus Medical Treatment of Atrial Fibrillation in Heart Failure (The CAMTAF Trial)

Hunter

Berriman

Diab

et al. 2014

Circ: Arrhythmia and Electrophysiology

407

382

View full text Add to dashboard Cite

Background-Restoring sinus rhythm in patients with heart failure (HF) and atrial fibrillation (AF) may improve left ventricular (LV) function and HF symptoms. We sought to compare the effect of a catheter ablation strategy with that of a medical rate control strategy in patients with persistent AF and HF. Methods and Results-Patients with persistent AF, symptomatic HF, and LV ejection fraction <50% were randomized to catheter ablation or medical rate control. The primary end-point was the difference between groups in LV ejection fraction at 6 months. Baseline LV ejection fraction was 32±8% in the ablation group and 34±12% in the medical group. Twentysix patients underwent catheter ablation, and 24 patients were rate controlled. Freedom from AF was achieved in 21/26 (81%) at 6 months off antiarrhythmic drugs. LV ejection fraction at 6 months in the ablation group was 40±12% compared with 31±13% in the rate control group (P=0.015

show abstract

“…Specifically, AV delay programming and biventricular triggering parameters may have a role in improving the percentage of BiVP. 20,30,36 Meanwhile, it seems reasonable not to perform AVN ablation systematically at the time of CRT implantation, but instead to perform it a few weeks later if BiVP is suboptimal (<95%-99%) despite adequate pharmacological optimization of ventricular heart rate. Results of ongoing randomized studies may further clarify whether AVN ablation should routinely accompany CRT in patients with AF.…”

mentioning

confidence: 99%

Effects of Atrioventricular Nodal Ablation on Permanent Atrial Fibrillation Patients With Cardiac Resynchronization Therapy: A Systematic Review and Meta‐analysis

Yin

Wang

et al. 2014

Clinical Cardiology

View full text Add to dashboard Cite

Cardiac resynchronization therapy (CRT) is a well-established therapy for patients with heart failure (HF) and wide QRS configuration, especially for those in sinus rhythm. However, for those with permanent AF, atrioventricular nodal (AVN) ablation use remains under debate. Our objective was to evaluate clinical outcomes and mortality of AVN ablation in HF patients with permanent AF receiving CRT. Electronic publication database and reference lists through October 1, 2013 were searched. Observational cohort studies comparing CRT patients with AF who received either AVN ablation or medical therapy were selected. Outcomes included mortality, CRT nonresponse, changes in left ventricular remodeling, and functional outcomes, such as New York Heart Association (NYHA) functional class, quality of life, and 6-minute hall walk distance. Of 1641 reports identified, 13 studies with 1256 patients were included. Among patients with permanent AF and insufficient biventricular pacing (<90%), those who had undergone AVN ablation compared to those who did not had numerically lower all-cause mortality (risk ratio [RR]: 0.63, 95% confidence interval [CI]: 0.42 to 0.96, P = 0.03) and significantly lower nonresponse to CRT (RR: 0.41, 95% CI: 0.31 to 0.54, P < 0.00001). Furthermore, AVN ablation was not associated with additional improvements on left ventricular ejection fraction, NYHA functional class, 6-minute hall walking distance, and quality of life. In patients with permanent AF undergoing CRT, AVN ablation tended to reduce mortality potentially and improved clinical response when it was applied to patients with inadequate biventricular pacing (<90%). Randomized controlled trials are needed to further address the efficacy of AVN ablation among this population.

show abstract

Meta-Analysis of the Effectiveness and Safety of Catheter Ablation of Atrial Fibrillation in Patients With Versus Without Left Ventricular Systolic Dysfunction

Cited by 101 publications

References 28 publications

Atrial Fibrillation and Heart Failure: Update 2015

Atrial Fibrillation and Heart Failure: Update 2015

A Randomized Controlled Trial of Catheter Ablation Versus Medical Treatment of Atrial Fibrillation in Heart Failure (The CAMTAF Trial)

Effects of Atrioventricular Nodal Ablation on Permanent Atrial Fibrillation Patients With Cardiac Resynchronization Therapy: A Systematic Review and Meta‐analysis

Contact Info

Product

Resources

About