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- Title
Effect of catheter ablation on clinical outcomes in patients with atrial fibrillation and significant functional mitral regurgitation.
- Authors
Wu, Jin-Tao; Zhao, Dan-Qing; Zhang, Fu-Tao; Liu, Xiao-Jie; Hu, Juan; Zhang, Lei-Ming; Fan, Xian-Wei; Yang, Hai-Tao; Yan, Li-Jie; Liu, Jing-Jing; Wang, Shan-Ling
- Abstract
<bold>Background: </bold>In patients with atrial fibrillation (AF) and functional mitral regurgitation (MR), catheter ablation reduces the severity of MR and improves cardiac remodeling. However, its effects on prognosis are uncertain.<bold>Methods: </bold>This retrospective study included 151 consecutive patients with AF and functional MR, 82 (54.3%) of whom were treated by catheter ablation (Ablation group) and 69 (45.7%) with drug therapy without ablation (Non-ablation group). Forty-three pairs of these patients were propensity matched on the basis of age, CHA2DS2-VASc scores, and left ventricular ejection fraction. The primary outcome evaluated was severity of MR, cardiac remodeling and the combined incidence of subsequent heart failure-related hospitalization and strokes/transient ischemic attacks.<bold>Results: </bold>Patients in the Ablation group showed a significant decrease in the severity of MR (p < 0.001), a significant decrease in the left atrial diameter (p = 0.010), and significant improvement in the left ventricular ejection fraction (p = 0.015). However, patients in the Non-ablation group showed only a significant decrease in the severity of MR (p = 0.004). The annual incidence of the studied events was 4.9% in the Ablation group and 16.7% in the Non-ablation group, the incidence being significantly lower in the ablation than Non-ablation group (p = 0.026) according to Kaplan-Meier curve analyses. According to multivariate Cox regression analysis, catheter ablation therapy (hazard ratio [HR] 0.27, 95% confidence interval [CI] 0.09-0.84; p = 0.024) and heart failure at baseline (HR 3.84, 95% CI 1.07-13.74; p = 0.038) were independent predictors of the incidence of the studied events.<bold>Conclusions: </bold>Among patients with AF and functional MR, catheter ablation was associated with a significantly lower combined risk of heart failure-related hospitalization and stroke than in a matched cohort of patients receiving drug therapy alone.
- Subjects
MITRAL valve insufficiency; HEART failure; CATHETER ablation; TREATMENT effectiveness; ATRIAL fibrillation; ABLATION techniques; TRANSIENT ischemic attack
- Publication
BMC Cardiovascular Disorders, 2021, Vol 21, Issue 1, p1
- ISSN
1471-2261
- Publication type
journal article
- DOI
10.1186/s12872-021-02397-5