Six-year clinical outcomes after catheter ablation of atrial fibrillation in patients with impaired left ventricular function

Andreas Rillig*, Hisaki Makimoto, Jascha Wegner, Tina Lin, Christian Heeger, Christine Lemes, Thomas Fink, Andreas Metzner, Erik Wissner, Shibu Mathew, Peter Wohlmuth, Karl Heinz Kuck, Roland Richard Tilz, Feifan Ouyang

*Corresponding author for this work
16 Citations (Scopus)

Abstract

AF Ablation in Patients With Impaired LVEF Introduction Long-term data after pulmonary vein isolation (PVI) in patients with impaired systolic left ventricular ejection fraction (LVEF) are sparse. This study assessed the outcomes in patients with atrial fibrillation (AF) and reduced LVEF treated with PVI after a median follow-up period of 6 years. Methods and Results Eighty-one patients with an LVEF≤45% were evaluated; however, 1 patient was lost to follow-up. In the remaining 80 patients (male: n = 68 (85%), median age 61.6 (54.8-67.5) years) with paroxysmal (n = 16, 20%), persistent (n = 37, 46.2%), and longstanding-persistent AF (LS-AF), catheter ablation of AF using radiofrequency and 3D mapping was performed. Follow-up included Holter monitoring or pacemaker/ICD interrogation to assess for arrhythmia recurrence and echocardiography to assess LVEF. Median follow-up was 72 (67-75) months. Death occurred in 21 patients. Single-procedure success rate was 35.1% and multiple-procedure success rate was 56.8% in the overall group. Baseline median LVEF (35% [28.5-40%]) significantly increased at 6-year follow-up (56.5% [40.0-60.0%], P < 0.01). In patients with single- or multiple-procedure ablation success, there was a higher improvement of LVEF (single procedure: 25% [15.0-35] vs. 10.0% [-1.0-20.0], P < 0.01; multiple procedures: 20.0% [15-34] vs. 5.0% [5.00-15.0]; P < 0.01). The single (43.8% vs. 40%, P = 0.96) and multiple procedure success rates (62.5% vs. 60%, P = 0.47) were comparable between patients with PAF and persistent AF and lowest in patients with LS-AF (single procedure success: 23.1%, multiple-procedure success: 47.8%). Conclusion Single-procedure success rates after PVI during 6 years of follow-up were low. In patients with single- or multiple-procedure ablation success, a higher improvement of LVEF was observed.

Original languageEnglish
JournalJournal of Cardiovascular Electrophysiology
Volume26
Issue number11
Pages (from-to)1169-1179
Number of pages11
ISSN1045-3873
DOIs
Publication statusPublished - 11.2015

Research Areas and Centers

  • Centers: Cardiological Center Luebeck (UHZL)

DFG Research Classification Scheme

  • 205-12 Cardiology, Angiology

Cite this