Cryoballoon Ablation in Older Patients With Heart Failure

Figures

• 

  Figure 1. Kaplan-Meier Cumulative Incidence Curves of Prognoses in Patients with HF Aged ≥75 or <75 Years AF recurrence (A), all-cause death (B), cardiovascular death (C), HF hospitalization (D), and death and HF hospitalization (E). AF = atrial fibrillation; HF = heart failure.

• 

  Figure 2. Estimated Risk of Outcomes After Cryoablation According to Age AF recurrence (A), all-cause death (B), HF hospitalization (C), and death and HF hospitalization (D). The estimated risks of adverse events were analyzed with age as a continuous variable. The solid blue line illustrates the estimated HR, with 95% CIs depicted as shaded areas. Abbreviations as in Figure 1.

• 

  Figure 3. Changes in BNP Levels and Echocardiographic Findings From Baseline to Postablation Regarding the association between BNP levels (A) and echocardiographic data (B and C) before and after treatment, we conducted a linear regression analysis using post-treatment value as the outcome variable, and pretreatment value and the measurement interval as covariates, taking into account the duration between measurements. BNP levels were logarithmically transformed for analysis. BNP = brain natriuretic peptide; LAD = left atrial diameter; LVEDD = left ventricular end-diastolic diameter; LVESD = left ventricular end-systolic diameter; LVEF = left ventricular ejection fraction; other abbreviation as in Figure 1.

• 

  Figure 4. Kaplan-Meier Survival Curves of Prognoses in Older Patients With or Without Recurrence All-cause death (A), cardiovascular death (B), HF hospitalization (C), and composite endpoint (D). Abbreviation as in Figure 1.

• 

  Figure 5. Changes in Parameters From Baseline to Postablation in Older Patients With or Without Recurrence Regarding the association between BNP levels and echocardiographic data before and after treatment, we conducted a linear regression analysis using post-treatment value as the outcome variable, and pretreatment value and the measurement interval as covariates, taking into account the duration between measurements. BNP levels were logarithmically transformed for analysis. BNP levels (A) and echocardiographic findings (B). Abbreviations as in Figure 3.

• 

  Figure 6. Changes in BNP Levels and LVEF After Ablation by Subgroups of Older Patients Abbreviations as in Figure 3.

• 

  Central Illustration. Cryoablation in Older Patients With HF The upper right panel shows the time to HF hospitalization between the recurrence and nonrecurrence groups among the older patients. 73% of HF hospitalizations in older patients occurred after more than 1 year postablation. The gray boxes represent the primary cause of HF hospitalization after ablation. Triggers for worsening HF were AF recurrence, medication nonadherence, discontinuation of hospital visits, and IHD incidence. The lower right panel shows the time to recurrence between patients with and without HF hospitalization among the older patients with recurrence. The median days to recurrence were 550 (156-652) vs 211 (125-510) days in the hospitalization and nonhospitalization groups, respectively. The patients with recurrence and HF hospitalization demonstrated a higher prevalence of CAD and a lower rate of TIC. CAD = coronary artery disease; CAVB = complete atrioventricular block; HT = hypertension; IHD = ischemic heart disease; TIC = tachycardia-induced cardiomyopathy; other abbreviations as in Figure 1.