Key result
Clinical heart failure occurred in 20% of patients within 30 days of atrial fibrillation ablation and correlated with higher left atrial pressure, mitral valve disease, and loop diuretic use.
Why the study?
Elevated LAP during AF ablation is linked to AF recurrence, but whether it correlates with incident HF events remains unknown.
Does elevated left atrial pressure during atrial fibrillation ablation correlate with early incident heart failure?
Cohort (n=100)
No
Does elevated left atrial pressure during atrial fibrillation ablation correlate with early incident heart failure?
Elevated left atrial pressure, mitral valve disease, and diuretic use correlate with an increased risk of early incident heart failure within 30 days after atrial fibrillation ablation.
Answers are grounded in this paper and cite their sources.
Elevated left atrial pressure may flag early post-ablation heart failure risk; leaves open whether targeted strategies improve outcomes.
INTRODUCTION: Elevated left atrial pressure (LAP) during catheter ablation of atrial fibrillation (AF) is associated with an increased risk of AF recurrence, but it is unknown if this correlates with heart failure (HF). The objective of the study was to determine if elevated LAP after AF ablation correlates with HF events. METHODS: Prospective, single-center, cohort study measuring LAP and right atrial pressure (RAP) during AF ablation in 100 patients. The primary endpoint was clinical HF within 30 days of ablation. The secondary outcome was AF-free HF. RESULTS: One hundred patients (63% male, mean age 64.5) were enrolled and 20% had clinical HF within 30 days. Bivariate correlates included mitral valve (MV) disease, persistent AF, class III antiarrhythmics, LAP, and recurrent AF. Multivariate analysis revealed class III antiarrhythmics were protective (odds ratio [OR]: 0.24 [0.1-0.5], p = .04), while MV disease (OR: 8.7 [3.3-23], p = .03) and loop diuretics (OR: 4.8 [2.6-9.1], p = .01) were hazardous. AF-free HF occurred in 9% of patients and correlated with higher LAP and RAP, and chronic kidney disease. CONCLUSION: Patients with HF after AF ablation had higher LAP. MV disease, diuretic use, and class III antiarrhythmics also correlated to HF. These present opportunities to target future interventions to reduce a common complication of AF ablation.
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Gilge et al. (2020) conducted a cohort in Atrial fibrillation (n=100). Catheter ablation was evaluated on Clinical HF within 30 days of ablation. Clinical heart failure occurred in 20% of patients within 30 days of atrial fibrillation ablation and correlated with higher left atrial pressure, mitral valve disease, and loop diuretic use.
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