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Published in: Heart and Vessels 4/2016

01-04-2016 | Original Article

Catheter ablation of atrial fibrillation in patients with severely impaired left ventricular systolic function

Authors: Ken Kato, Koichiro Ejima, Noritoshi Fukushima, Makoto Ishizawa, Osamu Wakisaka, Ryuta Henmi, Kentaro Yoshida, Toshiaki Nuki, Kotaro Arai, Bun Yashiro, Tetsuyuki Manaka, Kyomi Ashihara, Morio Shoda, Nobuhisa Hagiwara

Published in: Heart and Vessels | Issue 4/2016

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Abstract

Little is known about the outcome of catheter ablation of atrial fibrillation (AF) in patients with heart failure (HF) and a severely reduced left ventricular ejection fraction (LVEF). We aimed to clarify the effectiveness of catheter ablation of AF in patients with a severely low LVEF. This retrospective study included 18 consecutive patients with HF and an LVEF of ≤35 % who underwent catheter ablation of AF. We investigated the clinical parameters, echocardiographic parameters and the incidence of hospitalizations for HF. During a median follow-up of 21 months (IQR, 13–40) after the final procedure (9 with repeat procedures), 11 patients (61 %) maintained sinus rhythm (SR) (6 with amiodarone). The LVEF and NYHA class significantly improved at 6 months after the CA in 12 patients (67 %) who were in SR or had recurrent paroxysmal AF (from 25.8 ± 6.3 to 37.0 ± 11.7 %, P = 0.02, and from 2.3 ± 0.5 to 1.5 ± 0.7, P < 0.01, respectively) but not in patients who experienced recurrent persistent AF. The patients with SR or recurrent paroxysmal AF had significantly fewer hospitalizations for HF than those with recurrent persistent AF after the AF ablation (log-rank test; P < 0.01). Catheter ablation of AF improved the clinical status in patients with an LVEF of ≤35 %. A repeat ablation procedure and amiodarone were often necessary to obtain a favorable outcome.
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Metadata
Title
Catheter ablation of atrial fibrillation in patients with severely impaired left ventricular systolic function
Authors
Ken Kato
Koichiro Ejima
Noritoshi Fukushima
Makoto Ishizawa
Osamu Wakisaka
Ryuta Henmi
Kentaro Yoshida
Toshiaki Nuki
Kotaro Arai
Bun Yashiro
Tetsuyuki Manaka
Kyomi Ashihara
Morio Shoda
Nobuhisa Hagiwara
Publication date
01-04-2016
Publisher
Springer Japan
Published in
Heart and Vessels / Issue 4/2016
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-015-0635-7

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