Long-term impact of atrial fibrillation catheter ablation on heart failure with preserved ejection fraction.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Interventional Cardiac Electrophysiology Pub Date : 2024-12-23 DOI:10.1007/s10840-024-01939-z

Harsh Patel, Rezwan Munshi, Aakash Sheth, Siddharth Agarwal, Freddy Del-Carpio Munoz, Guru Kowlgi, Christopher V DeSimone, Mohamed Rafa Labedi, Sourbha Dani, Abhishek Deshmukh

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引用次数: 0

Abstract

Background: The efficacy of catheter ablation as a treatment approach for patients with concurrent atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) has been inadequately investigated.

Objective: This study's objective was to assess the effectiveness of atrial fibrillation ablation (AFA) in patients with heart failure with preserved ejection fraction.

Methods: Utilizing the TriNetX research network, we identified individuals aged 18 and older with atrial fibrillation (AF) and concurrent heart failure with preserved ejection fraction (HFpEF) from January 1, 2010, to June 1, 2021. Patients were further classified based on their catheter ablation procedure, using Current Procedural Terminology codes. Following propensity-score matching, each cohort consisted of 9440 patients. The primary endpoint was all-cause mortality at two years and secondary outcomes during the 2-year follow-up encompassing readmissions for heart failure, AF, and stroke.

Results: In propensity-matched cohort, patients with AF and HFpEF who underwent AFA plus medical therapy had significantly lower all-cause mortality at two years than those who did not undergo AFA (hazard ratio (HR): 0.37, 95% CI: 0.34-0.40; P < 0.001) even after matching antiarrhythmic medications. At two years, secondary outcomes including HF readmissions (HR: 0.86 95% CI: 0.84-0.89; P < 0.001) and stroke readmissions (HR: 0.66 95% CI: 0.59-0.73; P < 0.001) were lower in the AFA group.

Conclusion: AFA amongst AF patients with concomitant HFpEF showed a significant reduction in all-cause mortality. It also leads to significant reductions in readmissions due to HF and ischemic stroke at two years.

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房颤导管消融对保留射血分数的心力衰竭的长期影响。

背景：导管消融作为一种治疗伴有保留射血分数（HFpEF）的并发心房颤动（AF）和心力衰竭的方法的有效性尚未得到充分的研究。目的：本研究的目的是评估房颤消融（AFA）在保留射血分数的心力衰竭患者中的有效性。方法：利用TriNetX研究网络，从2010年1月1日至2021年6月1日，我们确定了18岁及以上的房颤（AF）和保留射血分数（HFpEF）并发心力衰竭患者。患者根据其导管消融程序进一步分类，使用现行程序术语代码。根据倾向评分匹配，每个队列由9440名患者组成。主要终点是2年时的全因死亡率，以及2年随访期间的次要终点，包括心力衰竭、房颤和中风的再入院。结果：在倾向匹配队列中，接受AFA +药物治疗的房颤和HFpEF患者两年时的全因死亡率显著低于未接受AFA的患者(风险比（HR）： 0.37, 95% CI: 0.34-0.40；结论：合并HFpEF的房颤患者发生AFA可显著降低全因死亡率。它还能显著减少两年后因心衰和缺血性卒中再入院的病例。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.