Atrial fibrillation ablation in heart failure patients: improved systolic function after cryoballoon pulmonary vein isolation
Abstract Aims Atrial fibrillation (AF) and heart failure (HF) are the most common cardiac diseases and often coexist leading to increased mortality and morbidity compared with AF patients without HF. As shown previously, AF ablation using radio frequency (RF) in HF patients leads to a reduction of A...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-10-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.12735 |
| _version_ | 1818734515432980480 |
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| author | Alexander Pott Saskia Jäck Christiane Schweizer Michael Baumhardt Tilman Stephan Manuel Rattka Karolina Weinmann Carlo Bothner Dominik Scharnbeck Mirjam Keßler Wolfgang Rottbauer Tillman Dahme |
| author_facet | Alexander Pott Saskia Jäck Christiane Schweizer Michael Baumhardt Tilman Stephan Manuel Rattka Karolina Weinmann Carlo Bothner Dominik Scharnbeck Mirjam Keßler Wolfgang Rottbauer Tillman Dahme |
| author_sort | Alexander Pott |
| collection | DOAJ |
| description | Abstract Aims Atrial fibrillation (AF) and heart failure (HF) are the most common cardiac diseases and often coexist leading to increased mortality and morbidity compared with AF patients without HF. As shown previously, AF ablation using radio frequency (RF) in HF patients leads to a reduction of AF burden, an increase of left ventricular ejection fraction (LVEF) and consequently to reduced hospitalization and mortality. Previous AF ablation studies on HF patients have been liberal about additional targets beyond pulmonary vein isolation (PVI). Thus, the aim of this study was to assess systematically the impact of a straightforward PVI‐only strategy on LVEF, NYHA functional class, and cardiovascular hospitalization rate in HF patients. Methods and results Out of 414 consecutive patients undergoing PVI, only with the cryoballoon 113 patients with reduced LVEF [mean: 38.4 ± 10.8%, reduced ejection fraction (rEF) group] and 301 patients with normal LVEF (>55%) at baseline were identified [normal ejection fraction (nEF) group]. Remarkably, even though freedom from arrhythmia recurrence after 1 year was significantly lower in the rEF group (64.9%) compared with the nEF group (71.2%, P = 0.036), mean LVEF improved from 38.4 ± 10.8% to 52.5 ± 17.2% (P < 0.001) after cryoballoon ablation in the rEF group. Accordingly, HF‐related symptoms as well as hospitalization rate declined significantly in the rEF group during follow‐up compared with baseline. Conclusions The results of the present study suggest that catheter ablation restricted to a straightforward PVI‐only strategy using the cryoballoon leads to improved left ventricular ejection fraction as well as improvement of NYHA functional class and increased freedom from cardiovascular rehospitalization. |
| first_indexed | 2024-12-18T00:06:35Z |
| format | Article |
| id | doaj.art-b9bd112cf25a4dd890cb4fd44f4a7ed3 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-18T00:06:35Z |
| publishDate | 2020-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-b9bd112cf25a4dd890cb4fd44f4a7ed32022-12-21T21:27:47ZengWileyESC Heart Failure2055-58222020-10-01752258226710.1002/ehf2.12735Atrial fibrillation ablation in heart failure patients: improved systolic function after cryoballoon pulmonary vein isolationAlexander Pott0Saskia Jäck1Christiane Schweizer2Michael Baumhardt3Tilman Stephan4Manuel Rattka5Karolina Weinmann6Carlo Bothner7Dominik Scharnbeck8Mirjam Keßler9Wolfgang Rottbauer10Tillman Dahme11Medicine II Ulm University Medical Center Ulm GermanyMedicine II Ulm University Medical Center Ulm GermanyMedicine II Ulm University Medical Center Ulm GermanyMedicine II Ulm University Medical Center Ulm GermanyMedicine II Ulm University Medical Center Ulm GermanyMedicine II Ulm University Medical Center Ulm GermanyMedicine II Ulm University Medical Center Ulm GermanyMedicine II Ulm University Medical Center Ulm GermanyMedicine II Ulm University Medical Center Ulm GermanyMedicine II Ulm University Medical Center Ulm GermanyMedicine II Ulm University Medical Center Ulm GermanyMedicine II Ulm University Medical Center Ulm GermanyAbstract Aims Atrial fibrillation (AF) and heart failure (HF) are the most common cardiac diseases and often coexist leading to increased mortality and morbidity compared with AF patients without HF. As shown previously, AF ablation using radio frequency (RF) in HF patients leads to a reduction of AF burden, an increase of left ventricular ejection fraction (LVEF) and consequently to reduced hospitalization and mortality. Previous AF ablation studies on HF patients have been liberal about additional targets beyond pulmonary vein isolation (PVI). Thus, the aim of this study was to assess systematically the impact of a straightforward PVI‐only strategy on LVEF, NYHA functional class, and cardiovascular hospitalization rate in HF patients. Methods and results Out of 414 consecutive patients undergoing PVI, only with the cryoballoon 113 patients with reduced LVEF [mean: 38.4 ± 10.8%, reduced ejection fraction (rEF) group] and 301 patients with normal LVEF (>55%) at baseline were identified [normal ejection fraction (nEF) group]. Remarkably, even though freedom from arrhythmia recurrence after 1 year was significantly lower in the rEF group (64.9%) compared with the nEF group (71.2%, P = 0.036), mean LVEF improved from 38.4 ± 10.8% to 52.5 ± 17.2% (P < 0.001) after cryoballoon ablation in the rEF group. Accordingly, HF‐related symptoms as well as hospitalization rate declined significantly in the rEF group during follow‐up compared with baseline. Conclusions The results of the present study suggest that catheter ablation restricted to a straightforward PVI‐only strategy using the cryoballoon leads to improved left ventricular ejection fraction as well as improvement of NYHA functional class and increased freedom from cardiovascular rehospitalization.https://doi.org/10.1002/ehf2.12735Atrial fibrillationHeart failureCryoballoonLeft ventricular systolic functionHospitalizationPulmonary vein isolation |
| spellingShingle | Alexander Pott Saskia Jäck Christiane Schweizer Michael Baumhardt Tilman Stephan Manuel Rattka Karolina Weinmann Carlo Bothner Dominik Scharnbeck Mirjam Keßler Wolfgang Rottbauer Tillman Dahme Atrial fibrillation ablation in heart failure patients: improved systolic function after cryoballoon pulmonary vein isolation ESC Heart Failure Atrial fibrillation Heart failure Cryoballoon Left ventricular systolic function Hospitalization Pulmonary vein isolation |
| title | Atrial fibrillation ablation in heart failure patients: improved systolic function after cryoballoon pulmonary vein isolation |
| title_full | Atrial fibrillation ablation in heart failure patients: improved systolic function after cryoballoon pulmonary vein isolation |
| title_fullStr | Atrial fibrillation ablation in heart failure patients: improved systolic function after cryoballoon pulmonary vein isolation |
| title_full_unstemmed | Atrial fibrillation ablation in heart failure patients: improved systolic function after cryoballoon pulmonary vein isolation |
| title_short | Atrial fibrillation ablation in heart failure patients: improved systolic function after cryoballoon pulmonary vein isolation |
| title_sort | atrial fibrillation ablation in heart failure patients improved systolic function after cryoballoon pulmonary vein isolation |
| topic | Atrial fibrillation Heart failure Cryoballoon Left ventricular systolic function Hospitalization Pulmonary vein isolation |
| url | https://doi.org/10.1002/ehf2.12735 |
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