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Clinical outcomes and structural remodelling after ablation of atrial fibrillation in heart failure with mildly reduced or mid-range ejection fraction.
| Content Provider | Europe PMC |
|---|---|
| Author | Lee, Dan‐Ying Chang, Ting‐Yung Chang, Shih‐Lin Lin, Yenn‐Jiang Lo, Li‐Wei Hu, Yu‐Feng Chung, Fa‐Po Tuan, Ta‐Chuan Chao, Tze‐Fan Liao, Jo‐Nan Lin, Chin‐Yu Kuo, Ling Liu, Chih‐Min Chen, Shih‐Ann |
| Abstract | AimsThe efficacy of catheter ablation (CA) on clinical outcomes and cardiac structural remodelling in atrial fibrillation (AF) patients with HF with mildly reduced or mid‐range ejection fraction (HFmrEF) remains unclear. We aimed to compare the efficacy of CA with medical therapy (MT) in AF patients with HFmrEF.Methods and resultsWe retrospectively screened a total of 36 879 patients with AF between 2005 and 2020. Patients who were initially diagnosed with echocardiography‐proved HFmrEF and had follow‐up echocardiography were enrolled. After applying propensity score matching in a 1:1 ratio, 72 patients treated by CA (Group 1) and 72 patients receiving MT (Group 2) were taken into further analysis. The co‐morbidities were similar between the two groups, except for hyperlipidaemia. After a mean follow‐up duration of 58.9 ± 42.6 months, Group 1 had a lower HF hospitalization and all‐cause mortality compared with Group 2 (hazard ratio (HR), 0.089 [95% confidence interval (CI), 0.011–0.747]; P = 0.026 and HR, 0.121 [95% CI, 0.016–0.894]; P = 0.038, respectively). As for cardiac structural remodelling, the Group 1 had a better improvement in left ventricular ejection fraction (LVEF) and a more decreased left atrium (LA) diameter than Group 2 (+25.0% ± 18.0% vs. +6.2% ± 21.6%, P = <0.0001 and −1.6 ± 4.7 mm vs. +1.5 ± 8.2 mm, P = 0.008, respectively).ConclusionsIn patients with HFmrEF and AF, CA of AF could reduce both HF hospitalization and all‐cause mortality as compared with those with MT. A significant improvement in LVEF and decrease in LA diameter were also observed in the CA group. Early rhythm control with CA should be taken into consideration in patients with HFmrEF and AF. |
| Page Count | 12 |
| Journal | ESC Heart Failure |
| Volume Number | 10 |
| PubMed Central reference number | PMC9871718 |
| Issue Number | 1 |
| PubMed reference number | 36178105 |
| e-ISSN | 20555822 |
| DOI | 10.1002/ehf2.14178 |
| Language | English |
| Publisher | John Wiley and Sons Inc. |
| Publisher Date | 2022-09-30 |
| Publisher Place | Hoboken |
| Access Restriction | Open |
| Rights License | This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. © 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. |
| Subject Keyword | Ablation Atrial fibrillation Heart failure Mildly reduced ejection fraction Outcome |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cardiology and Cardiovascular Medicine |
