Key result
Catheter ablation successfully restored normal sinus rhythm in 100% of patients with persistent atrial fibrillation and Class IV systolic heart failure, with 71% maintaining normal rhythm at a mean follow-up of 23 months.
Why the study?
Patients with advanced systolic congestive heart failure have historically been under-represented in multicenter clinical ablation trials, leaving questions about the role of catheter ablation for atrial fibrillation in this population.
Does catheter ablation improve maintenance of normal sinus rhythm in patients with persistent atrial fibrillation and Class IV systolic heart failure?
Does catheter ablation improve maintenance of normal sinus rhythm in patients with persistent atrial fibrillation and Class IV systolic heart failure?
Catheter ablation for persistent atrial fibrillation in patients with Class IV systolic heart failure on advanced therapies is feasible and can successfully maintain normal sinus rhythm.
Feasibility suggested in select Class IV HF patients; leaves open whether benefits outweigh risks pending prospective data.
Questions remain as to how aggressively catheter ablation for atrial fibrillation may be applied to patients with advanced systolic congestive heart failure, owing to a historic under-representation in multicenter clinical ablation trials. We sought to describe the experience of catheter ablation for persistent atrial fibrillation in Class IV systolic heart failure patients at our institution. All Class IV systolic heart failure patients (left ventricular assist device patients excluded) between 2017 and 2020 referred for radiofrequency ablation were included. Out of 10 patients, 7 agreed to proceed, had restoration of normal sinus rhythm upon completion of the catheter ablation procedure, and of which five (71%) remain in normal rhythm at a mean follow-up of 23 months. Catheter ablation for atrial fibrillation in patients with Class IV chronic systolic heart failure, even on advanced heart failure therapies, is feasible, and can improve heart failure status with maintenance of NSR.
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A 2020 study studied Persistent Atrial Fibrillation in Class IV Systolic Heart Failure (n=7). Catheter Ablation was evaluated on Maintenance of normal sinus rhythm at follow-up. Catheter ablation successfully restored normal sinus rhythm in 100% of patients with persistent atrial fibrillation and Class IV systolic heart failure, with 71% maintaining normal rhythm at a mean follow-up of 23 months.
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