We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Five-Year Outcomes of Catheter Ablation in Patients with Atrial Fibrillation and Left Ventricular Systolic Dysfunction.
- Authors
BUNCH, T. JARED; MAY, HEIDI T.; BAIR, TAMI L.; JACOBS, VICTORIA; CRANDALL, BRIAN G.; CUTLER, MICHAEL; WEISS, J. PETER; MALLENDER, CHARLES; OSBORN, JEFFREY S.; ANDERSON, JEFFREY L.; DAY, JOHN D.
- Abstract
Catheter Ablation and Long-Term Outcomes Background Catheter ablation of atrial fibrillation (AF) is an established therapy for symptomatic patients. The long-term efficacy and impact of catheter ablation among patients with severe systolic heart failure (SHF) requires additional study to understand if outcomes achieved at 1 year are maintained and mechanisms of AF recurrence. Methods Three groups with SHF and 5 years of follow-up were matched 1:4:4 by age (±5 years) and sex: AF ablation patients receiving their first ablation (n = 267), AF patients that did not receive an ablation (n = 1,068), and SHF patient without AF (n = 1,068). SHF was based upon clinical diagnosis and an ejection fraction (EF) ≤35%. Patients were followed for 5-year primary outcomes of AF recurrence, heart failure, stroke, death, and cardiac function. Results At 5 years, 60.7% of patients had clinical recurrence of AF. Diabetes and a prior heart attack were significant predictors of long-term risk of AF recurrence. Long-term mortality rates were 27%, 55%, 50%, in the AF ablation, AF, and no AF groups, respectively (P < 0.0001), with the lower rates attributed to lower cardiovascular mortality. At 5 years, there was no difference in EF, yet HF hospitalizations were lower following AF ablation compared to patients with AF and no ablation. Stroke rates at 5 years trended to be lower in the AF ablation group, but the difference was not statistically significant. Conclusion Recurrence rates of AF in patients with SHF after ablation are common at 5 years with an anticipated ongoing increase. Long-term AF-related comorbidities tended to be less in the AF ablation group.
- Subjects
ANTIHYPERTENSIVE agents; DRUG therapy; WARFARIN; HEART ventricle diseases; ATRIAL fibrillation; CATHETER ablation; CHI-squared test; DEMOGRAPHY; DIABETES; CARDIAC contraction; LEFT heart ventricle; HEART failure; HYPERLIPIDEMIA; HYPERTENSION; STROKE; SURVIVAL; T-test (Statistics); LOGISTIC regression analysis; TREATMENT effectiveness; DATA analysis software; ODDS ratio
- Publication
Journal of Cardiovascular Electrophysiology, 2015, Vol 26, Issue 4, p363
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/jce.12602