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Catheter ablation of atrial fibrillation in patients with severely impaired left ventricular systolic function

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Abstract

Little is known about the outcome of catheter ablation of atrial fibrillation (AF) in patients with heart failure (HF) and a severely reduced left ventricular ejection fraction (LVEF). We aimed to clarify the effectiveness of catheter ablation of AF in patients with a severely low LVEF. This retrospective study included 18 consecutive patients with HF and an LVEF of ≤35 % who underwent catheter ablation of AF. We investigated the clinical parameters, echocardiographic parameters and the incidence of hospitalizations for HF. During a median follow-up of 21 months (IQR, 13–40) after the final procedure (9 with repeat procedures), 11 patients (61 %) maintained sinus rhythm (SR) (6 with amiodarone). The LVEF and NYHA class significantly improved at 6 months after the CA in 12 patients (67 %) who were in SR or had recurrent paroxysmal AF (from 25.8 ± 6.3 to 37.0 ± 11.7 %, P = 0.02, and from 2.3 ± 0.5 to 1.5 ± 0.7, P < 0.01, respectively) but not in patients who experienced recurrent persistent AF. The patients with SR or recurrent paroxysmal AF had significantly fewer hospitalizations for HF than those with recurrent persistent AF after the AF ablation (log-rank test; P < 0.01). Catheter ablation of AF improved the clinical status in patients with an LVEF of ≤35 %. A repeat ablation procedure and amiodarone were often necessary to obtain a favorable outcome.

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Acknowledgments

We thank Mr. John Martin for the linguistic assistance in the preparation of this manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Cardiology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Ken Kato, Koichiro Ejima, Noritoshi Fukushima, Makoto Ishizawa, Osamu Wakisaka, Ryuta Henmi, Kentaro Yoshida, Toshiaki Nuki, Kotaro Arai, Bun Yashiro, Tetsuyuki Manaka, Kyomi Ashihara, Morio Shoda & Nobuhisa Hagiwara

  2. Department of Public Health, Tokyo Women’s Medical University, Tokyo, Japan

    Noritoshi Fukushima

  3. Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University School of Medicine, Takamatsu, Kagawa, Japan

    Makoto Ishizawa

  4. Department of Cardiology, Oita Medical Center, Oita, Japan

    Osamu Wakisaka

  5. Department of Cardiology, Sendai Cardiovascular Center, Sendai, Miyagi, Japan

    Bun Yashiro

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  1. Ken Kato
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  2. Koichiro Ejima
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  14. Nobuhisa Hagiwara
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Correspondence to Koichiro Ejima.

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Kato, K., Ejima, K., Fukushima, N. et al. Catheter ablation of atrial fibrillation in patients with severely impaired left ventricular systolic function. Heart Vessels 31, 584–592 (2016). https://doi.org/10.1007/s00380-015-0635-7

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  • DOI: https://doi.org/10.1007/s00380-015-0635-7

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