Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic Outcomes
Background:Heart failure and atrial fibrillation (AF) often coexist in a deleterious cycle.Objective:To evaluate the clinical and echocardiographic outcomes of patients with ventricular systolic dysfunction and AF treated with radiofrequency (RF) ablation.Methods:Patients with ventricular systolic dysfunction [ejection fraction (EF) <50%] and AF refractory to drug therapy underwent stepwise RF ablation in the same session with pulmonary vein isolation, ablation of AF nests and of residual atrial tachycardia, named "background tachycardia". Clinical (NYHA functional class) and echocardiographic (EF, left atrial diameter) data were compared (McNemar test and t test) before and after ablation.Results:31 patients (6 women, 25 men), aged 37 to 77 years (mean, 59.8±10.6), underwent RF ablation. The etiology was mainly idiopathic (19 p, 61%). During a mean follow-up of 20.3±17 months, 24 patients (77%) were in sinus rhythm, 11 (35%) being on amiodarone. Eight patients (26%) underwent more than one procedure (6 underwent 2 procedures, and 2 underwent 3 procedures). Significant NYHA functional class improvement was observed (pre-ablation: 2.23±0.56; postablation: 1.13±0.35; p<0.0001). The echocardiographic outcome also showed significant ventricular function improvement (EF pre: 44.68%±6.02%, post: 59%±13.2%, p=0.0005) and a significant left atrial diameter reduction (pre: 46.61±7.3 mm; post: 43.59±6.6 mm; p=0.026). No major complications occurred.Conclusion:Our findings suggest that AF ablation in patients with ventricular systolic dysfunction is a safe and highly effective procedure. Arrhythmia control has a great impact on ventricular function recovery and functional class improvement.
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Sociedade Brasileira de Cardiologia - SBC
2015
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oai:scielo:S0066-782X20150001000072015-11-04Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic OutcomesLobo,Tasso JulioPachon,Carlos ThienePachon,Jose CarlosPachon,Enrique IndalecioPachon,Maria ZeliaPachon,Juan CarlosSantillana,Tomas GuillermoZerpa,Juan CarlosAlbornoz,Remy NelsonJatene,Adib Domingos Catheter Ablation Atrial Fibrillation Ventricular Dsyfunction Echocardiography Arrhythmias, Cardiac Background:Heart failure and atrial fibrillation (AF) often coexist in a deleterious cycle.Objective:To evaluate the clinical and echocardiographic outcomes of patients with ventricular systolic dysfunction and AF treated with radiofrequency (RF) ablation.Methods:Patients with ventricular systolic dysfunction [ejection fraction (EF) <50%] and AF refractory to drug therapy underwent stepwise RF ablation in the same session with pulmonary vein isolation, ablation of AF nests and of residual atrial tachycardia, named "background tachycardia". Clinical (NYHA functional class) and echocardiographic (EF, left atrial diameter) data were compared (McNemar test and t test) before and after ablation.Results:31 patients (6 women, 25 men), aged 37 to 77 years (mean, 59.8±10.6), underwent RF ablation. The etiology was mainly idiopathic (19 p, 61%). During a mean follow-up of 20.3±17 months, 24 patients (77%) were in sinus rhythm, 11 (35%) being on amiodarone. Eight patients (26%) underwent more than one procedure (6 underwent 2 procedures, and 2 underwent 3 procedures). Significant NYHA functional class improvement was observed (pre-ablation: 2.23±0.56; postablation: 1.13±0.35; p<0.0001). The echocardiographic outcome also showed significant ventricular function improvement (EF pre: 44.68%±6.02%, post: 59%±13.2%, p=0.0005) and a significant left atrial diameter reduction (pre: 46.61±7.3 mm; post: 43.59±6.6 mm; p=0.026). No major complications occurred.Conclusion:Our findings suggest that AF ablation in patients with ventricular systolic dysfunction is a safe and highly effective procedure. Arrhythmia control has a great impact on ventricular function recovery and functional class improvement.info:eu-repo/semantics/openAccessSociedade Brasileira de Cardiologia - SBCArquivos Brasileiros de Cardiologia v.104 n.1 20152015-01-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2015000100007en10.5935/abc.20140167 |
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Lobo,Tasso Julio Pachon,Carlos Thiene Pachon,Jose Carlos Pachon,Enrique Indalecio Pachon,Maria Zelia Pachon,Juan Carlos Santillana,Tomas Guillermo Zerpa,Juan Carlos Albornoz,Remy Nelson Jatene,Adib Domingos |
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Lobo,Tasso Julio Pachon,Carlos Thiene Pachon,Jose Carlos Pachon,Enrique Indalecio Pachon,Maria Zelia Pachon,Juan Carlos Santillana,Tomas Guillermo Zerpa,Juan Carlos Albornoz,Remy Nelson Jatene,Adib Domingos Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic Outcomes |
author_facet |
Lobo,Tasso Julio Pachon,Carlos Thiene Pachon,Jose Carlos Pachon,Enrique Indalecio Pachon,Maria Zelia Pachon,Juan Carlos Santillana,Tomas Guillermo Zerpa,Juan Carlos Albornoz,Remy Nelson Jatene,Adib Domingos |
author_sort |
Lobo,Tasso Julio |
title |
Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic Outcomes |
title_short |
Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic Outcomes |
title_full |
Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic Outcomes |
title_fullStr |
Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic Outcomes |
title_full_unstemmed |
Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic Outcomes |
title_sort |
atrial fibrillation ablation in systolic dysfunction: clinical and echocardiographic outcomes |
description |
Background:Heart failure and atrial fibrillation (AF) often coexist in a deleterious cycle.Objective:To evaluate the clinical and echocardiographic outcomes of patients with ventricular systolic dysfunction and AF treated with radiofrequency (RF) ablation.Methods:Patients with ventricular systolic dysfunction [ejection fraction (EF) <50%] and AF refractory to drug therapy underwent stepwise RF ablation in the same session with pulmonary vein isolation, ablation of AF nests and of residual atrial tachycardia, named "background tachycardia". Clinical (NYHA functional class) and echocardiographic (EF, left atrial diameter) data were compared (McNemar test and t test) before and after ablation.Results:31 patients (6 women, 25 men), aged 37 to 77 years (mean, 59.8±10.6), underwent RF ablation. The etiology was mainly idiopathic (19 p, 61%). During a mean follow-up of 20.3±17 months, 24 patients (77%) were in sinus rhythm, 11 (35%) being on amiodarone. Eight patients (26%) underwent more than one procedure (6 underwent 2 procedures, and 2 underwent 3 procedures). Significant NYHA functional class improvement was observed (pre-ablation: 2.23±0.56; postablation: 1.13±0.35; p<0.0001). The echocardiographic outcome also showed significant ventricular function improvement (EF pre: 44.68%±6.02%, post: 59%±13.2%, p=0.0005) and a significant left atrial diameter reduction (pre: 46.61±7.3 mm; post: 43.59±6.6 mm; p=0.026). No major complications occurred.Conclusion:Our findings suggest that AF ablation in patients with ventricular systolic dysfunction is a safe and highly effective procedure. Arrhythmia control has a great impact on ventricular function recovery and functional class improvement. |
publisher |
Sociedade Brasileira de Cardiologia - SBC |
publishDate |
2015 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2015000100007 |
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