Characteristics of Patients with Heart Failure Undergoing Catheter Ablation of Atrial Fibrillation

• Published in: Journal of cardiac failure Vol. 24; no. 8; p. S64
• Main Authors: Jayanna, Manju Bengaluru, Mohsen, Ala, Dezorzi, Christopher, Shantha, Ghanshyam Palamaner Subash, Inampudi, Chakradhari, Giudici, Michael, Briasoulis, Alexandros
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.08.2018
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2018.07.278

Previous studies have shown benefit of catheter ablation of atrial fibrillation in patients with heart failure(HF). This study aims to study characteristics of patients with heart failure undergoing catheter ablation of atrial fibrillation (AF). In this retrospective cohort study, we analyzed 269 consecutive patients with mean age of 61 years who underwent catheter ablation for AF. 64 patients (24%) had known history of Stage C heart failure including both Heart failure with reduced ejection fraction and preserved ejection fraction. We compared baseline characteristics at the time of ablation and procedure outcomes between patients who had known heart failure to those who did not. At the time of the procedure, patients with HF had significantly higher body mass index (34.4vs32.3 p=0.0432), CHADS2Vasc score (2.6 vs 1.8 p<0.0001), heart rate (81 vs 73 p=0.0023), coronary artery disease (28% vs 15% p=0.0186) and left atrial enlargement by echocardiogram (53%vs29% p=0.0008). Other baseline characteristics including age, sex, race, comorbidities including valvular heart disease, hypertension, diabetes mellitus, peripheral vascular disease, sleep apnea were similar. Procedure duration was significantly longer in patients with HF (300 minutes vs 262 minutes p=0.0016) but other procedure characteristics including radiation exposure, fluoroscopy time, periprocedural complications were similar. Amongst patients with available follow up, patients with HF had higher unadjusted rates of recurrence at 3 months, (33%vs 17% p=0.0095 Relative risk(RR) 1.97(1.19-3.2 95%CI) and at 1 year (48% vs 29% p=0.0120 RR=1.13-2.4 95%CI). However, on logistic regression analysis adjusting for left atrial size and CHADS2Vasc score as covariates there was no significant difference. Patients with HF undergoing catheter ablation of AF tend to have more risk factors for recurrence but after adjustment for risk factors, the recurrence rates were similar at 3 months and 1 year.