Catheter ablation in patients with non-paroxysmal AF and HFpEF resulted in a 16.4% AF recurrence rate at 1 year, comparable to patients with HFrEF or no HF, and improved cardiac function.
Cohort (n=502)
Does catheter ablation improve sinus rhythm maintenance, cardiac function, and BNP levels in patients with non-paroxysmal AF and HFpEF compared to those with HFrEF or no HF?
Catheter ablation is a feasible and effective strategy for restoring sinus rhythm, improving cardiac function, and reducing BNP levels in patients with non-paroxysmal AF and coexisting HFpEF.
AIMS: We aimed to examine the benefits of catheter ablation in patients with non-paroxysmal atrial fibrillation (AF) accompanied by heart failure (HF) with preserved ejection fraction (HFpEF), in comparison with the benefits in patients with AF accompanied by HF with reduced ejection fraction (HFrEF) or patients with no HF. METHODS AND RESULTS: From 1173 consecutive patients undergoing catheter ablation, 502 with non-paroxysmal AF were divided into three groups: no history of HF plasma B-type natriuretic peptide (BNP) <100 pg/mL and no HF hospitalization; n = 125, HFpEF left ventricular (LV) EF ≥50%; n = 293, and HF with midrange EF (HFmrEF) + HFrEF (LVEF <50%; n = 84) groups. The endpoints were AF recurrence at 1 year, changes in symptomatic and image-based functional status, and changes in BNP levels from baseline to 1 year. In the HFpEF group, AF recurred in 48 patients (16.4%) and 278 patients (94.8%) had sinus rhythm at 1 year; these values were comparable with those in the other groups. Significant improvement was observed in the left atrial diameter, LVEF, and New York Heart Association functional class in the HFpEF and HFmrEF + HFrEF groups. The BNP level significantly decreased irrespective of the index rate control status, and freedom from AF recurrence was an independent predictor of HF remission, defined as BNP <100 pg/mL at 1 year, in the HFpEF group. CONCLUSION: Catheter ablation is highly feasible for restoring sinus rhythm in non-paroxysmal AF with coexisting HFpEF, thereby improving cardiac function and BNP levels. Catheter ablation for AF may be an optional management strategy.
Yamauchi et al. (Tue,) conducted a cohort in Non-paroxysmal atrial fibrillation with heart failure with preserved ejection fraction (HFpEF) (n=502). Catheter ablation vs. Patients with HFrEF or no heart failure was evaluated on AF recurrence at 1 year, changes in symptomatic and image-based functional status, and changes in BNP levels. Catheter ablation in patients with non-paroxysmal AF and HFpEF resulted in a 16.4% AF recurrence rate at 1 year, comparable to patients with HFrEF or no HF, and improved cardiac function.