PMID- 19556251
OWN - NLM
STAT- MEDLINE
DCOM- 20091008
LR  - 20090728
IS  - 1532-2092 (Electronic)
IS  - 1099-5129 (Linking)
VI  - 11
IP  - 8
DP  - 2009 Aug
TI  - Sinus rhythm restoration by catheter ablation in patients with long-lasting 
      atrial fibrillation and congestive heart failure: impact of the left ventricular 
      ejection fraction improvement on the implantable cardioverter defibrillator 
      insertion indication.
PG  - 1018-23
LID - 10.1093/europace/eup167 [doi]
AB  - AIMS: In the setting of congestive heart failure (CHF), atrial fibrillation (AF) 
      ablation can improve clinical status and the left ventricular ejection fraction 
      (LVEF) value. However, the impact of AF ablation on the implantable cardioverter 
      defibrillator (ICD) indication has never been specifically addressed. METHODS AND 
      RESULTS: Study subject were six CHF (mean age 61.1 +/- 6.9 years, mean LVEF 25.8 
      +/- 7.3%) patients refractory to conventional medical treatment with long-lasting 
      AF unresponsive to external cardioversion. Five patients had an idiopathic 
      dilated cardiomyopathy (DCM) and one had an ischaemic cardiomyopathy (ICM). Their 
      New York Heart Association (NYHA) class was III-IV. Two patients had renal 
      insufficiency. No patient had left ventricular delay. All patients underwent AF 
      ablation. LVEF and NYHA class were dramatically improved in the five DCM 
      patients. New York Heart Association class, but not the LVEF, was improved in the 
      ICM patient. A redo ablative procedure was undertaken in four of five DCM 
      patients and in the ICM patient due to arrhythmia recurrence. Left ventricular 
      ejection fraction and NYHA were improved again in the DCM patients (56 +/- 4.4%, 
      I-II, respectively) and led to ICD indication preclusion. The LVEF remained low 
      in the ICM patient (30%) and led to ICD insertion. Sinus rhythm has been stable 
      during the 18.1 +/- 5.7 months follow-up period. CONCLUSION: Atrial fibrillation 
      ablation in CHF patients can improve both the clinical status of patients and 
      their LVEF, especially among those affected by DCM. The LVEF improvement has the 
      potential to preclude the indication for a primary prevention ICD insertion.
FAU - Bortone, Agustin
AU  - Bortone A
AD  - Departement de Rythmologie, Hopital Prive Les Franciscaines, Unite de 
      Cardiologie, Nimes, France. agubene@hotmail.com
FAU - Boveda, Serge
AU  - Boveda S
FAU - Pasquie, Jean-Luc
AU  - Pasquie JL
FAU - Pujadas-Berthault, Penelope
AU  - Pujadas-Berthault P
FAU - Marijon, Eloi
AU  - Marijon E
FAU - Appetiti, Anthony
AU  - Appetiti A
FAU - Albenque, Jean-Paul
AU  - Albenque JP
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20090625
PL  - England
TA  - Europace
JT  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal 
      of the working groups on cardiac pacing, arrhythmias, and cardiac cellular 
      electrophysiology of the European Society of Cardiology
JID - 100883649
SB  - IM
MH  - Atrial Fibrillation/*complications/*prevention & control
MH  - Catheter Ablation/*methods
MH  - Combined Modality Therapy
MH  - *Defibrillators, Implantable
MH  - Female
MH  - Heart Failure/*complications/*prevention & control
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Stroke Volume
MH  - Treatment Outcome
EDAT- 2009/06/27 09:00
MHDA- 2009/10/09 06:00
CRDT- 2009/06/27 09:00
PHST- 2009/06/27 09:00 [entrez]
PHST- 2009/06/27 09:00 [pubmed]
PHST- 2009/10/09 06:00 [medline]
AID - eup167 [pii]
AID - 10.1093/europace/eup167 [doi]
PST - ppublish
SO  - Europace. 2009 Aug;11(8):1018-23. doi: 10.1093/europace/eup167. Epub 2009 Jun 25.