PMID- 29222043
OWN - NLM
STAT- MEDLINE
DCOM- 20181211
LR  - 20181211
IS  - 1556-3871 (Electronic)
IS  - 1547-5271 (Linking)
VI  - 15
IP  - 5
DP  - 2018 May
TI  - Catheter ablation of atrial fibrillation in patients with heart failure and 
      preserved ejection fraction.
PG  - 651-657
LID - S1547-5271(17)31422-4 [pii]
LID - 10.1016/j.hrthm.2017.12.001 [doi]
AB  - BACKGROUND: Few studies have examined outcomes of catheter ablation for atrial 
      fibrillation (AF) in patients with heart failure (HF) with preserved ejection 
      fraction (HFpEF). OBJECTIVE: The purpose of this study was to compare outcomes of 
      AF ablation in patients with HFpEF vs HF with reduced ejection fraction (HFrEF). 
      METHODS: We performed a retrospective study of 230 patients with HF who underwent 
      AF ablation, including 97 (42.2%) with HFrEF and 133 (57.8%) with HFpEF. Outcomes 
      included adverse events, symptoms (Mayo AF Symptom Inventory [MAFSI]), New York 
      Heart Association (NYHA) functional class, and freedom from recurrent atrial 
      arrhythmia at 12 months. RESULTS: Overall, 150 of 230 patients had nonparoxysmal 
      AF (62.8% HFpEF vs 63.0% HFrEF). Patients with HFpEF had a smaller mean left 
      atrial diameter (4.4 +/- 0.8 cm vs 4.7 +/- 0.7 cm; P = .013) and were less likely to 
      be taking a beta-blocker at baseline (72.9% vs 85.6%; P = .022). Median (Q1, Q3) 
      procedure times (233 minutes [192, 290] vs 233.5 minutes [193.0, 297.5]; P = 
      .780) and adverse events such as acute HF (3.8% vs 6.2%; P = .395) were similar 
      between HFpEF and HFrEF patients. Freedom from recurrent atrial arrhythmia was 
      not significantly different in HFpEF vs HFrEF patients (33.9% vs 32.6%; adjusted 
      hazard ratio 1.47; 95% confidence interval 0.72-3.01), with similar improvements 
      in NYHA functional class (-0.32 vs -0.19; P = .135) and MAFSI symptom severity 
      (-0.23 vs -0.09; P = .116) after ablation. CONCLUSION: Catheter ablation of AF 
      seems to have similar effectiveness in patients with HF, regardless of presence 
      of systolic dysfunction. There were no significant differences in procedural 
      characteristics, arrhythmia-free recurrence, or functional improvements between 
      patients with HFpEF and those with HFrEF.
CI  - Copyright (c) 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights 
      reserved.
FAU - Black-Maier, Eric
AU  - Black-Maier E
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina.
FAU - Ren, Xinru
AU  - Ren X
AD  - Department of Biostatistics and Bioinformatics, Duke University Medical Center, 
      Durham, North Carolina.
FAU - Steinberg, Benjamin A
AU  - Steinberg BA
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina.
FAU - Green, Cynthia L
AU  - Green CL
AD  - Department of Biostatistics and Bioinformatics, Duke University Medical Center, 
      Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina.
FAU - Barnett, Adam S
AU  - Barnett AS
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina.
FAU - Rosa, Normita Sta
AU  - Rosa NS
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina.
FAU - Al-Khatib, Sana M
AU  - Al-Khatib SM
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina; Duke Clinical Research Institute, Durham, North Carolina.
FAU - Atwater, Brett D
AU  - Atwater BD
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina; Duke Clinical Research Institute, Durham, North Carolina.
FAU - Daubert, James P
AU  - Daubert JP
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina.
FAU - Frazier-Mills, Camille
AU  - Frazier-Mills C
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina.
FAU - Grant, Augustus O
AU  - Grant AO
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina.
FAU - Hegland, Donald D
AU  - Hegland DD
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina.
FAU - Jackson, Kevin P
AU  - Jackson KP
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina.
FAU - Jackson, Larry R
AU  - Jackson LR
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina.
FAU - Koontz, Jason I
AU  - Koontz JI
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina.
FAU - Lewis, Robert K
AU  - Lewis RK
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina.
FAU - Sun, Albert Y
AU  - Sun AY
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina.
FAU - Thomas, Kevin L
AU  - Thomas KL
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina; Duke Clinical Research Institute, Durham, North Carolina.
FAU - Bahnson, Tristam D
AU  - Bahnson TD
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina; Duke Clinical Research Institute, Durham, North Carolina.
FAU - Piccini, Jonathan P
AU  - Piccini JP
AD  - Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, 
      North Carolina; Duke Clinical Research Institute, Durham, North Carolina. 
      Electronic address: jonathan.piccini@duke.edu.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20171206
PL  - United States
TA  - Heart Rhythm
JT  - Heart rhythm
JID - 101200317
SB  - IM
CIN - Heart Rhythm. 2018 May;15(5):658-659. PMID: 29428607
MH  - Aged
MH  - Atrial Fibrillation/complications/physiopathology/*surgery
MH  - Catheter Ablation/*methods
MH  - *Electrocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Conduction System/*physiopathology/surgery
MH  - Heart Failure/*complications/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Quality of Life
MH  - Recurrence
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Stroke Volume/*physiology
MH  - Systole
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Antiarrhythmic
OT  - Atrial fibrillation
OT  - Catheter ablation
OT  - Comparative effectiveness
OT  - Heart failure
OT  - Quality of life
EDAT- 2017/12/10 06:00
MHDA- 2018/12/12 06:00
CRDT- 2017/12/10 06:00
PHST- 2017/04/04 00:00 [received]
PHST- 2017/12/10 06:00 [pubmed]
PHST- 2018/12/12 06:00 [medline]
PHST- 2017/12/10 06:00 [entrez]
AID - S1547-5271(17)31422-4 [pii]
AID - 10.1016/j.hrthm.2017.12.001 [doi]
PST - ppublish
SO  - Heart Rhythm. 2018 May;15(5):651-657. doi: 10.1016/j.hrthm.2017.12.001. Epub 2017 
      Dec 6.