Key result
Extensive catheter ablation for atrial fibrillation was associated with new onset congestive heart failure in 2.5% of patients, all of whom recovered within 3 days with supportive therapy.
Why the study?
What is the prevalence and clinical course of new-onset congestive heart failure following extensive catheter ablation for atrial fibrillation?
Observational (n=484)
No
What is the prevalence and clinical course of new-onset congestive heart failure following extensive catheter ablation for atrial fibrillation?
Extensive catheter ablation for atrial fibrillation carries a 2.5% risk of acute, transient new-onset congestive heart failure that resolves quickly with supportive care.
Supports monitoring for transient post-ablation heart failure; leaves open causal links and generalizability in prospective trials.
INTRODUCTION: This study sought to describe a new complication of catheter ablation for atrial fibrillation (AF): new onset congestive heart failure (CHF) after extensive ablation for AF. METHODS AND RESULTS: Data from 12 patients developing CHF after ablation were prospectively collected. All patients underwent extensive ablation for AF including circumferential pulmonary venous ablation and complex fractionated atrial electrograms guided ablation. CHF was diagnosed using the following criteria: symptoms or signs of heart failure, elevated BNP, and echocardiographic evidence of left ventricular diastolic dysfunction. Twelve patients (5 persistent and 7 permanent AF) had CHF after extensive ablation out of 484 consecutive AF patients who underwent catheter ablation (prevalence 2.5%). None of these 12 patients had CHF prior to the procedure. The mean onset of the symptoms was 39 ± 14 hours after the index procedure. Dyspnea and pulmonary rales were the most observed symptoms or signs. White blood cell count, serum CRP, BNP, and echocardiographic parameters of left ventricular diastolic dysfunction (E/A, E/E') were significantly increased after the onset of symptoms. All patients had complete recovery with supportive therapy within 3 days of the onset of symptoms. CONCLUSIONS: In this single-center experience, CHF after extensive ablation for AF was a well-recognized complication with a relatively high incidence of 2.5%. Measurement of BNP, CRP, and E/A, E/E' is useful in managing these patients.
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TAN et al. (2011) conducted an observational in Atrial fibrillation (n=484). Extensive catheter ablation was evaluated on New onset congestive heart failure. Extensive catheter ablation for atrial fibrillation was associated with new onset congestive heart failure in 2.5% of patients, all of whom recovered within 3 days with supportive therapy.
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