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Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic Outcomes
BACKGROUND: Heart failure and atrial fibrillation (AF) often coexist in a deleterious cycle. OBJECTIVE: To evaluate the clinical and echocardiographic outcomes of patients with ventricular systolic dysfunction and AF treated with radiofrequency (RF) ablation. METHODS: Patients with ventricular systo...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Cardiologia
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4387610/ https://www.ncbi.nlm.nih.gov/pubmed/25387404 http://dx.doi.org/10.5935/abc.20140167 |
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author | Lobo, Tasso Julio Pachon, Carlos Thiene Pachon, Jose Carlos Pachon, Enrique Indalecio Pachon, Maria Zelia Pachon, Juan Carlos Santillana, Tomas Guillermo Zerpa, Juan Carlos Albornoz, Remy Nelson Jatene, Adib Domingos |
author_facet | Lobo, Tasso Julio Pachon, Carlos Thiene Pachon, Jose Carlos Pachon, Enrique Indalecio Pachon, Maria Zelia Pachon, Juan Carlos Santillana, Tomas Guillermo Zerpa, Juan Carlos Albornoz, Remy Nelson Jatene, Adib Domingos |
author_sort | Lobo, Tasso Julio |
collection | PubMed |
description | BACKGROUND: Heart failure and atrial fibrillation (AF) often coexist in a deleterious cycle. OBJECTIVE: To evaluate the clinical and echocardiographic outcomes of patients with ventricular systolic dysfunction and AF treated with radiofrequency (RF) ablation. METHODS: Patients with ventricular systolic dysfunction [ejection fraction (EF) <50%] and AF refractory to drug therapy underwent stepwise RF ablation in the same session with pulmonary vein isolation, ablation of AF nests and of residual atrial tachycardia, named "background tachycardia". Clinical (NYHA functional class) and echocardiographic (EF, left atrial diameter) data were compared (McNemar test and t test) before and after ablation. RESULTS: 31 patients (6 women, 25 men), aged 37 to 77 years (mean, 59.8±10.6), underwent RF ablation. The etiology was mainly idiopathic (19 p, 61%). During a mean follow-up of 20.3±17 months, 24 patients (77%) were in sinus rhythm, 11 (35%) being on amiodarone. Eight patients (26%) underwent more than one procedure (6 underwent 2 procedures, and 2 underwent 3 procedures). Significant NYHA functional class improvement was observed (pre-ablation: 2.23±0.56; postablation: 1.13±0.35; p<0.0001). The echocardiographic outcome also showed significant ventricular function improvement (EF pre: 44.68%±6.02%, post: 59%±13.2%, p=0.0005) and a significant left atrial diameter reduction (pre: 46.61±7.3 mm; post: 43.59±6.6 mm; p=0.026). No major complications occurred. CONCLUSION: Our findings suggest that AF ablation in patients with ventricular systolic dysfunction is a safe and highly effective procedure. Arrhythmia control has a great impact on ventricular function recovery and functional class improvement. |
format | Online Article Text |
id | pubmed-4387610 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Sociedade Brasileira de Cardiologia |
record_format | MEDLINE/PubMed |
spelling | pubmed-43876102015-04-08 Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic Outcomes Lobo, Tasso Julio Pachon, Carlos Thiene Pachon, Jose Carlos Pachon, Enrique Indalecio Pachon, Maria Zelia Pachon, Juan Carlos Santillana, Tomas Guillermo Zerpa, Juan Carlos Albornoz, Remy Nelson Jatene, Adib Domingos Arq Bras Cardiol Original Articles BACKGROUND: Heart failure and atrial fibrillation (AF) often coexist in a deleterious cycle. OBJECTIVE: To evaluate the clinical and echocardiographic outcomes of patients with ventricular systolic dysfunction and AF treated with radiofrequency (RF) ablation. METHODS: Patients with ventricular systolic dysfunction [ejection fraction (EF) <50%] and AF refractory to drug therapy underwent stepwise RF ablation in the same session with pulmonary vein isolation, ablation of AF nests and of residual atrial tachycardia, named "background tachycardia". Clinical (NYHA functional class) and echocardiographic (EF, left atrial diameter) data were compared (McNemar test and t test) before and after ablation. RESULTS: 31 patients (6 women, 25 men), aged 37 to 77 years (mean, 59.8±10.6), underwent RF ablation. The etiology was mainly idiopathic (19 p, 61%). During a mean follow-up of 20.3±17 months, 24 patients (77%) were in sinus rhythm, 11 (35%) being on amiodarone. Eight patients (26%) underwent more than one procedure (6 underwent 2 procedures, and 2 underwent 3 procedures). Significant NYHA functional class improvement was observed (pre-ablation: 2.23±0.56; postablation: 1.13±0.35; p<0.0001). The echocardiographic outcome also showed significant ventricular function improvement (EF pre: 44.68%±6.02%, post: 59%±13.2%, p=0.0005) and a significant left atrial diameter reduction (pre: 46.61±7.3 mm; post: 43.59±6.6 mm; p=0.026). No major complications occurred. CONCLUSION: Our findings suggest that AF ablation in patients with ventricular systolic dysfunction is a safe and highly effective procedure. Arrhythmia control has a great impact on ventricular function recovery and functional class improvement. Sociedade Brasileira de Cardiologia 2015-01 /pmc/articles/PMC4387610/ /pubmed/25387404 http://dx.doi.org/10.5935/abc.20140167 Text en http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Lobo, Tasso Julio Pachon, Carlos Thiene Pachon, Jose Carlos Pachon, Enrique Indalecio Pachon, Maria Zelia Pachon, Juan Carlos Santillana, Tomas Guillermo Zerpa, Juan Carlos Albornoz, Remy Nelson Jatene, Adib Domingos Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic Outcomes |
title | Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and
Echocardiographic Outcomes |
title_full | Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and
Echocardiographic Outcomes |
title_fullStr | Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and
Echocardiographic Outcomes |
title_full_unstemmed | Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and
Echocardiographic Outcomes |
title_short | Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and
Echocardiographic Outcomes |
title_sort | atrial fibrillation ablation in systolic dysfunction: clinical and
echocardiographic outcomes |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4387610/ https://www.ncbi.nlm.nih.gov/pubmed/25387404 http://dx.doi.org/10.5935/abc.20140167 |
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