Outcomes after stepwise ablation for persistent atrial fibrillation in patients with heart failure
Background: There is limited data regarding the outcomes after stepwise ablation for persistent atrial fibrillation (AF) in patients with heart failure (HF). Methods and results: Patients without structural heart disease undergoing stepwise ablation for persistent AF (continuous AF≤1 year) were stud...
Main Authors: | , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Wiley
2012-12-01
|
Series: | Journal of Arrhythmia |
Subjects: | |
Online Access: | http://www.sciencedirect.com/science/article/pii/S1880427612000907 |
id |
doaj-42c8cf7370d941cc9ef0727ec5cdd585 |
---|---|
record_format |
Article |
spelling |
doaj-42c8cf7370d941cc9ef0727ec5cdd5852020-11-24T23:54:17ZengWileyJournal of Arrhythmia1880-42762012-12-0128634735210.1016/j.joa.2012.05.010Outcomes after stepwise ablation for persistent atrial fibrillation in patients with heart failureYoshihide Takahashi, MD0Atsushi Takahashi, MD1Taishi Kuwahara, MD2Kenji Okubo, MD3Katsumasa Takagi, MD4Yuji Watari, MD5Masateru Takigawa, MD6Emiko Nakashima, MD7Naohiko Kawaguchi, MD8Kazuya Yamao, MD9Kenzo Hirao, MD10Mitsuaki Isobe, MD11The Department of Cardiovascular Medicine, National Disaster Medical Center, Tokyo, JapanThe Cardiovascular Center, Yokosuka Kyousai Hospital, Yokosuka, JapanThe Cardiovascular Center, Yokosuka Kyousai Hospital, Yokosuka, JapanThe Cardiovascular Center, Yokosuka Kyousai Hospital, Yokosuka, JapanThe Cardiovascular Center, Yokosuka Kyousai Hospital, Yokosuka, JapanThe Cardiovascular Center, Yokosuka Kyousai Hospital, Yokosuka, JapanThe Cardiovascular Center, Yokosuka Kyousai Hospital, Yokosuka, JapanThe Cardiovascular Center, Yokosuka Kyousai Hospital, Yokosuka, JapanThe Cardiovascular Center, Yokosuka Kyousai Hospital, Yokosuka, JapanThe Cardiovascular Center, Yokosuka Kyousai Hospital, Yokosuka, JapanThe Heart Rhythm Center, Tokyo Medical and Dental University, JapanThe Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, JapanBackground: There is limited data regarding the outcomes after stepwise ablation for persistent atrial fibrillation (AF) in patients with heart failure (HF). Methods and results: Patients without structural heart disease undergoing stepwise ablation for persistent AF (continuous AF≤1 year) were studied (n=108; age, 61±10 years) and 32 patients had a history of HF. The HF patients were further grouped on the basis of left ventricular ejection fraction (LVEF)≤45% (n=15) and >45% (n=17). During a median follow-up period of 2.2 years, repeated ablations were necessary in 65 patients. The proportion of patients that were arrhythmia free 1 year after the last ablation was 67% in patients with LVEF≤45%, 86% in LVEF>45%, and 91% in no HF (p=0.0009). In patients with LVEF≤45%, the AF burden was reduced to less than one paroxysmal episode per month, and patients with and without recurrences both showed significant increases in LVEF over the follow-up period (38±7% to 60±10% and 37±6% to 53±10%, respectively). Conclusions: HF patients with LVEF≤45% had lower chances to remain free from arrhythmias after stepwise ablation for persistent AF than those with LVEF>45%. Nevertheless, LVEF also improved in patients with recurrences, reflecting the observed reduction in AF burden and emphasizing the benefits of ablation.http://www.sciencedirect.com/science/article/pii/S1880427612000907FibrillationAblationHeart failure |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yoshihide Takahashi, MD Atsushi Takahashi, MD Taishi Kuwahara, MD Kenji Okubo, MD Katsumasa Takagi, MD Yuji Watari, MD Masateru Takigawa, MD Emiko Nakashima, MD Naohiko Kawaguchi, MD Kazuya Yamao, MD Kenzo Hirao, MD Mitsuaki Isobe, MD |
spellingShingle |
Yoshihide Takahashi, MD Atsushi Takahashi, MD Taishi Kuwahara, MD Kenji Okubo, MD Katsumasa Takagi, MD Yuji Watari, MD Masateru Takigawa, MD Emiko Nakashima, MD Naohiko Kawaguchi, MD Kazuya Yamao, MD Kenzo Hirao, MD Mitsuaki Isobe, MD Outcomes after stepwise ablation for persistent atrial fibrillation in patients with heart failure Journal of Arrhythmia Fibrillation Ablation Heart failure |
author_facet |
Yoshihide Takahashi, MD Atsushi Takahashi, MD Taishi Kuwahara, MD Kenji Okubo, MD Katsumasa Takagi, MD Yuji Watari, MD Masateru Takigawa, MD Emiko Nakashima, MD Naohiko Kawaguchi, MD Kazuya Yamao, MD Kenzo Hirao, MD Mitsuaki Isobe, MD |
author_sort |
Yoshihide Takahashi, MD |
title |
Outcomes after stepwise ablation for persistent atrial fibrillation in patients with heart failure |
title_short |
Outcomes after stepwise ablation for persistent atrial fibrillation in patients with heart failure |
title_full |
Outcomes after stepwise ablation for persistent atrial fibrillation in patients with heart failure |
title_fullStr |
Outcomes after stepwise ablation for persistent atrial fibrillation in patients with heart failure |
title_full_unstemmed |
Outcomes after stepwise ablation for persistent atrial fibrillation in patients with heart failure |
title_sort |
outcomes after stepwise ablation for persistent atrial fibrillation in patients with heart failure |
publisher |
Wiley |
series |
Journal of Arrhythmia |
issn |
1880-4276 |
publishDate |
2012-12-01 |
description |
Background: There is limited data regarding the outcomes after stepwise ablation for persistent atrial fibrillation (AF) in patients with heart failure (HF).
Methods and results: Patients without structural heart disease undergoing stepwise ablation for persistent AF (continuous AF≤1 year) were studied (n=108; age, 61±10 years) and 32 patients had a history of HF. The HF patients were further grouped on the basis of left ventricular ejection fraction (LVEF)≤45% (n=15) and >45% (n=17). During a median follow-up period of 2.2 years, repeated ablations were necessary in 65 patients. The proportion of patients that were arrhythmia free 1 year after the last ablation was 67% in patients with LVEF≤45%, 86% in LVEF>45%, and 91% in no HF (p=0.0009). In patients with LVEF≤45%, the AF burden was reduced to less than one paroxysmal episode per month, and patients with and without recurrences both showed significant increases in LVEF over the follow-up period (38±7% to 60±10% and 37±6% to 53±10%, respectively).
Conclusions: HF patients with LVEF≤45% had lower chances to remain free from arrhythmias after stepwise ablation for persistent AF than those with LVEF>45%. Nevertheless, LVEF also improved in patients with recurrences, reflecting the observed reduction in AF burden and emphasizing the benefits of ablation. |
topic |
Fibrillation Ablation Heart failure |
url |
http://www.sciencedirect.com/science/article/pii/S1880427612000907 |
work_keys_str_mv |
AT yoshihidetakahashimd outcomesafterstepwiseablationforpersistentatrialfibrillationinpatientswithheartfailure AT atsushitakahashimd outcomesafterstepwiseablationforpersistentatrialfibrillationinpatientswithheartfailure AT taishikuwaharamd outcomesafterstepwiseablationforpersistentatrialfibrillationinpatientswithheartfailure AT kenjiokubomd outcomesafterstepwiseablationforpersistentatrialfibrillationinpatientswithheartfailure AT katsumasatakagimd outcomesafterstepwiseablationforpersistentatrialfibrillationinpatientswithheartfailure AT yujiwatarimd outcomesafterstepwiseablationforpersistentatrialfibrillationinpatientswithheartfailure AT masaterutakigawamd outcomesafterstepwiseablationforpersistentatrialfibrillationinpatientswithheartfailure AT emikonakashimamd outcomesafterstepwiseablationforpersistentatrialfibrillationinpatientswithheartfailure AT naohikokawaguchimd outcomesafterstepwiseablationforpersistentatrialfibrillationinpatientswithheartfailure AT kazuyayamaomd outcomesafterstepwiseablationforpersistentatrialfibrillationinpatientswithheartfailure AT kenzohiraomd outcomesafterstepwiseablationforpersistentatrialfibrillationinpatientswithheartfailure AT mitsuakiisobemd outcomesafterstepwiseablationforpersistentatrialfibrillationinpatientswithheartfailure |
_version_ |
1725466420328792064 |