Catheter ablation for persistent atrial fibrillation after acute decompensated heart failure Attack: Earlier is Better?

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-02-01 DOI:10.1016/j.ijcha.2024.101589

Qian-ji Che , Jun-hao Qiu , Jian Sun , Mu Chen , Wei Li , Qun-Shan Wang , Peng-Pai Zhang , Yu-li Yang , Rui Zhang , Yi-Gang Li

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引用次数: 0

Abstract

Background

Acute decompensated heart failure (ADHF) is often accompanied by persistent atrial fibrillation (AF). However, the optimal timing for RFCA in patients with persistent AF and ADHF is still uncertain.

Objectives

The aim of this observational cohort study is to investigate the safety and efficacy of early RFCA in patients with persistent AF after ADHF attack.

Methods

Patients with persistent AF and ADHF who underwent early RFCA as soon as the ADHF symptoms were initially controlled (Early group, n = 63) and those who received elective procedures after a transitional period (Elective group, n = 67) were investigated. After 1:1 propensity score matching, 50 matched pairs were analyzed.

Results

The overall procedural complication rates were similar (Early group: 6.0 %, n = 3; Elective group: 6.0 %, n = 3; P = 1.000). Patients in the early group had significantly less HF rehospitalization than the elective group during the 1-year post-procedure follow-up period (Mantel-Cox test: P = 0.036; HR: 0.369; 95 %CI: 0.145–0.938), though AF recurrence showed no difference (Mantel-Cox test: P = 0.645; HR: 1.204; 95 %CI: 0.547–2.648). A 90-day rehospitalization rate was significantly higher in the transitional period in the elective group, compared with patients who already received early RFCA (Elective group: 13, 26.0 %; Early group: 2, 4.0 %; P = 0.002).

Conclusions

Early RFCA therapy for persistent AF after ADHF attack was safe and effective. Patients who received early RFCA therapy had significantly less HF rehospitalization in the 1-year post-procedure follow-up period. On the other hand, the elective procedure was accompanied by a higher risk of HF rehospitalization during the waiting period.

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.