Key result
Atrial fibrillation ablation in patients with LVEF <50% was associated with an 86.1% rate of freedom from AF recurrence over a mean follow-up of 60 months.
Why the study?
Catheter ablation efficacy has been reported in patients with low cardiac function, but few studies have included mid-range ejection fraction.
Does atrial fibrillation ablation improve clinical and echocardiographic outcomes in heart failure patients with LVEF < 50%?
Observational (n=79)
No
Does atrial fibrillation ablation improve clinical and echocardiographic outcomes in heart failure patients with LVEF < 50%?
Atrial fibrillation ablation in patients with LVEF < 50% is associated with a high rate of freedom from AF recurrence and improvements in cardiac and renal function over long-term follow-up.
AF ablation may be feasible in LVEF <50% including mrEF; hypothesis-generating, needs prospective RCTs before practice change.
INTRODUCTION: The efficacy of catheter ablation in patients with low cardiac function has been previously reported; however, only a few studies have included mid-range ejection fraction (mrEF). This study aimed to evaluate the efficacy and safety of atrial fibrillation (AF) ablation in patients with left ventricular ejection fraction (LVEF) < 50%. METHODS: This study retrospectively analyzed 79 patients (reduced ejection fraction [rEF]/mrEF, 38/41; paroxysmal/persistent, 37/42; heart failure hospitalizations within one year before ablation, 36 [45.6%]) who underwent the first ablation procedure at our hospital from April 2017 to December 2021. Radiofrequency ablation and cryoablation were performed for 69 and 10 patients, respectively. RESULTS: Complications included pacemaker implantation for postoperative sick sinus syndrome in one patient and inguinal hematoma in one patient. Regarding efficacy, there were significant postoperative improvements in echocardiographic data, blood test values, and diuretic use. After a mean follow-up of 60 months, 86.1% patients had no AF recurrence. There were 9 heart failure hospitalizations (11.4%) and 5 all-cause deaths (6.3%); no significant differences were found between the rEF and mrEF groups. No significant predictors of AF recurrence were found in preoperative patient characteristics. CONCLUSION: AF ablation in patients with LVEF <50% significantly improved cardiac and renal functions with few complications, resulting in a high non-recurrence rate and reduced heart failure.
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Sakamoto et al. (2023) conducted an observational in Atrial fibrillation and heart failure with LVEF < 50% (n=79). Atrial fibrillation ablation was evaluated on No AF recurrence. Atrial fibrillation ablation in patients with LVEF <50% was associated with an 86.1% rate of freedom from AF recurrence over a mean follow-up of 60 months.
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