Success of Ablation for Atrial Fibrillation in Isolated Left Ventricular Diastolic Dysfunction
Key result
Radiofrequency ablation achieved AAD-free AF elimination at 1 year in 75% of patients with isolated diastolic dysfunction vs 84% of controls, with a higher recurrence risk (RR 1.7; 95% CI 1.0-2.7).
Why the study?
Does radiofrequency ablation improve AAD-free AF elimination in patients with AAD-refractory AF and LV systolic or isolated diastolic dysfunction compared to those with normal LV function?
Population
n=368 patients with antiarrhythmic drug-refractory atrial fibrillation undergoing ablation, comprising 111…
Comparison
Radiofrequency ablation vs Normal LV function group
Design
Cohort
Follow-up
1 year
Authors
Discussion
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Implication
May warrant closer monitoring after ablation in isolated diastolic dysfunction; leaves open randomized confirmation of efficacy.
Key Points
- This research examines the effectiveness of radiofrequency ablation for atrial fibrillation in patients with isolated diastolic dysfunction and those with systolic dysfunction.
- Prospective cohort study involving patients with normal and abnormal LV function
- Comparison of outcomes in three groups: systolic dysfunction, isolated diastolic dysfunction, and normal LV function
- Assessment of AAD-free AF elimination at 1 year after ablation
- AAD-free AF elimination achieved in 62% (systolic dysfunction), 75% (diastolic dysfunction), and 84% (controls), P=0.007
- 76% (systolic), 85% (diastolic), and 89% (controls) achieved AF control with AADs, P=0.08
- Relative risk of arrhythmia recurrence was 1.8 (systolic) and 1.7 (diastolic) compared to normal function, P=0.02 and P=0.04 respectively
Study Design
Type
Cohort (n=368)
Structured PICO
Does radiofrequency ablation improve AAD-free AF elimination in patients with AAD-refractory AF and LV systolic or isolated diastolic dysfunction compared to those with normal LV function?
P
Population
n=368 patients with antiarrhythmic drug (AAD)-refractory atrial fibrillation (AF) undergoing ablation, comprising 111 with systolic dysfunction (LVEF ≤40%), 157 with isolated diastolic dysfunction (LVEF ≥50%), and 100 with normal LV function.
I
Intervention
Radiofrequency ablation
C
Comparator
Normal LV function group (for the dysfunction groups)
O
Outcome
AAD-free AF elimination at 1 year after ablationhard clinical
Main Result
Absolute Event Rate: 75% vs 84%
p-value: p=0.007
Radiofrequency ablation for AAD-refractory AF is less effective in maintaining sinus rhythm in patients with systolic or diastolic dysfunction compared to those with normal LV function, though it still provides functional benefits.
Cite This Study
Cha et al. (2011) conducted a cohort in Antiarrhythmic drug-refractory atrial fibrillation (n=368). Radiofrequency ablation vs. Normal LV function was evaluated on AAD-free AF elimination at 1 year after ablation (p=0.007). Radiofrequency ablation achieved AAD-free AF elimination at 1 year in 75% of patients with isolated diastolic dysfunction vs 84% of controls, with a higher recurrence risk (RR 1.7; 95% CI 1.0-2.7).