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Nagaoka, K; Mukai, Y; Kawai, S; Takase, S; Sakamoto, K; Inoue, S; Ikeda, S; Chishaki, A; Tsutsui, H

P1025Clinical predictors for the improvement of left ventricular ejection fraction and prognosis after catheter ablation of atrial fibrillation in patients with systolic dysfunction

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  • Media type: E-Article
  • Title: P1025Clinical predictors for the improvement of left ventricular ejection fraction and prognosis after catheter ablation of atrial fibrillation in patients with systolic dysfunction
  • Contributor: Nagaoka, K; Mukai, Y; Kawai, S; Takase, S; Sakamoto, K; Inoue, S; Ikeda, S; Chishaki, A; Tsutsui, H
  • imprint: Oxford University Press (OUP), 2019
  • Published in: European Heart Journal
  • Language: English
  • DOI: 10.1093/eurheartj/ehz747.0616
  • ISSN: 0195-668X; 1522-9645
  • Keywords: Cardiology and Cardiovascular Medicine
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Catheter ablation (CA) of atrial fibrillation (AF) improves left ventricular ejection fraction (LVEF) and clinical outcomes in patients with left ventricular systolic dysfunction (LVSD). However, predictors of the improvement of LV function and clinical outcomes by CA were poorly understood.</jats:p> </jats:sec> <jats:sec> <jats:title>Purpose</jats:title> <jats:p>We examined the efficacy of CA in AF patients with LVSD and predictive factors associated with clinical outcomes.</jats:p> </jats:sec> <jats:sec> <jats:title>Method</jats:title> <jats:p>Among consecutive 795 patients undergone initial RFCA at our hospital, we studied 51 patients with LVSD (LVEF ≤50%). Improved LVEF more then 5% at 1-year after CA was classified as “responder” to CA. We analyzed clinical variables and echocardiographic parameters before and after the CAs.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>In the responder group, LVEF was significantly improved 1-year after catheter ablation compared with the non-responder group. (ΔLVEF 22±12% vs. −1±4%, p&lt;0.001). The responder group was significantly younger, had more non-paroxysmal AF, smaller LV systolic diameter and lower plasma BNP level before CA (Table). Late gadolinium enhancement (LGE)-positive rate in cardiovascular magnetic resonance imaging (CMR) before CA was higher in the non-responder group than in the responder group (100% [6/6] vs. 38% [5/13], p&lt;0.005). After CAs of AF, event-free survival from hospitalization for heart failure was significantly higher in the responder group (Figure) with less AF recurrence (27% vs. 47%, p=0.04) than in the non-responder group.</jats:p> <jats:p>Baseline characteristics Responder (N=35) Non-Responder (N=16) P value Age, y 62±11 69±8 p&lt;0.01 Male, n (%) 26 (74) 13 (76) NS Non-pAF 26 (74) 4 (24) p&lt;0.01 LAD, mm 48±7 48±8 NS LAVI, ml/m2 54±17 58±20 NS LVDd, mm 54±7 58±10 NS LVDs, mm 43±7 48±10 p=0.05 EF, % 37±8 38±8 NS BNP (pg/ml) 278±225 684±848 p&lt;0.05</jats:p> <jats:p /> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Younger age, absence of LV dilatation, lower plasma BNP, or absence of LGE may well predict favorable clinical outcomes after CA in patients with LVSD.</jats:p> </jats:sec>
  • Access State: Open Access