Key result
In patients with chronic heart failure, increased left atrial diameter (4.59 vs 4.08 cm, p<0.001) and prolonged QTc interval (387.23 vs 341.22 ms, p<0.010) before radiofrequency ablation were significant predictors of atrial fibrillation recurrence.
Why the study?
The predictive power of demographic, hemodynamic, and electrocardiographic factors for atrial fibrillation recurrence after radiofrequency ablation in patients with chronic heart failure was investigated.
Cohort (n=120)
Prolonged QTc interval and enlarged left atrium diameter are independent predictors of atrial fibrillation recurrence after radiofrequency ablation in patients with HFpEF.
LA enlargement associated with AF recurrence; this Level 3 cohort finding leaves open its predictive utility.
OBJECTIVE: The aim: To study the predictive power of demographic, hemodynamic and electrocardiographic factors for atrial fibrillation recurrence after radiofrequency ablation (RFA) in patients with chronic heart failure. PATIENTS AND METHODS: Materials and methods: Study included 120 patients, aged 59,80±10,08 years old with chronic heart failure with preserved left ventricular ejection fraction who were undergo RFA due to atrial fibrillation (AF). A standard 12-lead electrocardiogram (ECG) was registered. Before the procedure the standard echocardiographic parameters were obtained. After 12 months, patients were divided into 2 groups: non-recurrence group and recurrence group. RESULTS: Results: As a result of prospective follow-up within 12 months AF recurrences were observed in 32 patients (27%), 88 patients remained non-recurrent (73%). The left atrium (LA) diameter and aortic root diameter were lager in the recurrence group (4,59±0,45 vs. 4,08±0,61 cm, p<0,001; 3,37±0,60 vs. 2,80±0,67 cm, p<0,001). The AF recurrence group before RFA had a significantly longer QTc interval than the non-recurrence group (387,23±2,31 vs. 341,22±8,91 ms, p<0,010). ROC curve analysis revealed LA diameter the most sensitive factor for AF recurrence after RFA. CONCLUSION: Conclusions: QTc duration before radiofrequency ablation and its prolongation after intervention are independent predictors of atrial fibrillation recurrence; left atrium diameter before ablation is a highly sensitive predictor in patients with chronic heart failure with preserved left ventricular ejection fraction.
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Zolotarova et al. (2021) conducted a cohort in Chronic heart failure with preserved ejection fraction and atrial fibrillation (n=120). Increased left atrial diameter and prolonged QTc interval vs. Lower left atrial diameter and shorter QTc interval was evaluated on Atrial fibrillation recurrence at 12 months. In patients with chronic heart failure, increased left atrial diameter (4.59 vs 4.08 cm, p<0.001) and prolonged QTc interval (387.23 vs 341.22 ms, p<0.010) before radiofrequency ablation were significant predictors of atrial fibrillation recurrence.
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