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Rillig A, Makimoto H, Wegner J, et al. Six-Year Clinical Outcomes After Catheter Ablation of Atrial Fibrillation in Patients With Impaired Left Ventricular Function. J Cardiovasc Electrophysiol. 2015;26(11):1169-1179doi: 10.1111/jce.12765.
Rillig, A., Makimoto, H., Wegner, J., Lin, T., Heeger, C., Lemes, C., Fink, T., Metzner, A., Wissner, E., Mathew, S., Wohlmuth, P., Kuck, K. H., Tilz, R. R., & Ouyang, F. (2015). Six-Year Clinical Outcomes After Catheter Ablation of Atrial Fibrillation in Patients With Impaired Left Ventricular Function. Journal of cardiovascular electrophysiology, 26(11), 1169-1179. https://doi.org/10.1111/jce.12765
Rillig, Andreas, et al. "Six-Year Clinical Outcomes After Catheter Ablation of Atrial Fibrillation in Patients With Impaired Left Ventricular Function." Journal of cardiovascular electrophysiology vol. 26,11 (2015): 1169-1179. doi: https://doi.org/10.1111/jce.12765
Rillig A, Makimoto H, Wegner J, Lin T, Heeger C, Lemes C, Fink T, Metzner A, Wissner E, Mathew S, Wohlmuth P, Kuck KH, Tilz RR, Ouyang F. Six-Year Clinical Outcomes After Catheter Ablation of Atrial Fibrillation in Patients With Impaired Left Ventricular Function. J Cardiovasc Electrophysiol. 2015 Nov;26(11):1169-1179. doi: 10.1111/jce.12765. Epub 2015 Sep 03. PMID: 26217925.
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J Cardiovasc Electrophysiol. 2015 Nov;26(11):1169-1179. doi: 10.1111/jce.12765. Epub 2015 Sep 03.

Six-Year Clinical Outcomes After Catheter Ablation of Atrial Fibrillation in Patients With Impaired Left Ventricular Function.

Journal of cardiovascular electrophysiology

Andreas Rillig, Hisaki Makimoto, Jascha Wegner, Tina Lin, Christian Heeger, Christine Lemes, Thomas Fink, Andreas Metzner, Erik Wissner, Shibu Mathew, Peter Wohlmuth, Karl-Heinz Kuck, Roland Richard Tilz, Feifan Ouyang

Affiliations

  1. Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.
  2. Asklepios Proresearch, Hamburg, Germany.

PMID: 26217925 DOI: 10.1111/jce.12765

Abstract

INTRODUCTION: Long-term data after pulmonary vein isolation (PVI) in patients with impaired systolic left ventricular ejection fraction (LVEF) are sparse. This study assessed the outcomes in patients with atrial fibrillation (AF) and reduced LVEF treated with PVI after a median follow-up period of 6 years.

METHODS AND RESULTS: Eighty-one patients with an LVEF≤45% were evaluated; however, 1 patient was lost to follow-up. In the remaining 80 patients (male: n = 68 (85%), median age 61.6 (54.8-67.5) years) with paroxysmal (n = 16, 20%), persistent (n = 37, 46.2%), and longstanding-persistent AF (LS-AF), catheter ablation of AF using radiofrequency and 3D mapping was performed. Follow-up included Holter monitoring or pacemaker/ICD interrogation to assess for arrhythmia recurrence and echocardiography to assess LVEF. Median follow-up was 72 (67-75) months. Death occurred in 21 patients. Single-procedure success rate was 35.1% and multiple-procedure success rate was 56.8% in the overall group. Baseline median LVEF (35% [28.5-40%]) significantly increased at 6-year follow-up (56.5% [40.0-60.0%], P < 0.01). In patients with single- or multiple-procedure ablation success, there was a higher improvement of LVEF (single procedure: 25% [15.0-35] vs. 10.0% [-1.0-20.0], P < 0.01; multiple procedures: 20.0% [15-34] vs. 5.0% [5.00-15.0]; P < 0.01). The single (43.8% vs. 40%, P = 0.96) and multiple procedure success rates (62.5% vs. 60%, P = 0.47) were comparable between patients with PAF and persistent AF and lowest in patients with LS-AF (single procedure success: 23.1%, multiple-procedure success: 47.8%).

CONCLUSION: Single-procedure success rates after PVI during 6 years of follow-up were low. In patients with single- or multiple-procedure ablation success, a higher improvement of LVEF was observed.

© 2015 Wiley Periodicals, Inc.

Keywords: atrial fibrillation; catheter ablation; heart failure; impaired systolic ejection fraction; long-term follow-up; pulmonary vein isolation

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