Key result
Chronic myocarditis is linked to ~21 percentage points higher 12-month AF ablation success.
Why the study?
It was unknown whether the effectiveness of interventional treatment for AF differs between patients with chronic myocarditis and those without myocarditis.
Does the presence of chronic myocarditis affect the 12-month effectiveness of catheter ablation in patients with atrial fibrillation?
Cohort (n=40)
No
Does the presence of chronic myocarditis affect the 12-month effectiveness of catheter ablation in patients with atrial fibrillation?
Absolute Event Rate: 88.9% vs 67.5%
The presence of chronic myocarditis was associated with higher ablation success rates in this small cohort, highlighting the complex relationship between myocardial inflammation and arrhythmia recurrence.
Should not yet change ablation decisions in AF; leaves open whether myocarditis modifies outcomes in larger prospective studies.
Aim: To compare the effectiveness of interventional treatment of atrial fibrillation (AF) in patients with chronic myocarditis identified by endomyocardial biopsy and in patients without myocarditis. Material and Methods. The study sample included 40 patients. Of these, 27 (67.5%) are men. The age in the sample was 49 (44; 55) years. The study included 25 (62.5%) patients with paroxysmal AF, 10 (25.0%) with persistent and 5 (12.5%) with long-term persistent. All patients underwent surgical treatment of AF using radiofrequency ablation (RFA) or cryoablation (CA). Endomyocardial biopsy was performed in 18 patients to verify the diagnosis. The follow-up period for patients was 12 months. Results. All patients underwent surgical treatment of AF, in 7 cases (17.5%) CA of the left ventricle (LV) was performed; in 33 (82.5%) cases RFA was performed. According to the biopsy results, signs of myocarditis were detected in 9 patients (22.5%). Focal myocarditis was found in 7 patients, diffuse – in 2. The effectiveness of catheter treatment in general was 72.5%, for CA – 71.5%, for RFA 73.5%. The effectiveness of AF ablation with the presence of detected myocarditis was 88.9%, without myocarditis – 67.5%. Conclusions. The effectiveness of catheter treatment of AF in patients with signs of myocarditis was 88.9% and was higher than in patients without signs of myocarditis.
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Арчаков et al. (2024) conducted a cohort in Atrial fibrillation and chronic myocarditis (n=40). Presence of chronic myocarditis (verified by endomyocardial biopsy) vs. Absence of chronic myocarditis was evaluated on Effectiveness of catheter treatment (absence of arrhythmia during 12 months). The effectiveness of catheter ablation for atrial fibrillation at 12 months was 88.9% in patients with signs of chronic myocarditis compared to 67.5% in patients without signs of myocarditis.
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