title: Pulmonary vein vestibule ablation for the control of atrial fibrillation in patients with impaired left ventricular function.
abstract: BACKGROUND
  Congestive heart failure (CHF) and atrial fibrillation (AF) are frequently linked, and when associated produce additive deleterious effects. In this prospective study, the effects of catheter ablation for AF in patients with impaired left ventricular (LV) function are presented.
  
  
  METHODS
  Baseline data and clinical outcome have been prospectively collected in 105 consecutive patients who underwent pulmonary vein ablation for the control of AF. We evaluated 40 patients affected by LV dysfunction with ejection fraction (EF)<40% and compared them to the remaining 65 patients with normal ventricular function in terms of changes in LV function, maintenance of sinus rhythm, and quality of life during follow-up.
  
  
  RESULTS
  After a mean follow-up of 14+/-2 months, 87% of patients with impaired LV function and 92% of patients with normal ventricular function were in sinus rhythm, with or without antiarrhythmic therapy (P=NS). A significant improvement in LVEF and fractional shortening was documented in patients with CHF (33+/-2% vs 47+/-3%, and 19+/-4% vs 30+/-3%, P<0.01 for both comparisons). Evaluation of exercise capacity and quality of life documented better improvements in patients with CHF compared to patients without CHF.
  
  
  CONCLUSIONS
  Catheter ablation in patients with LV dysfunction is feasible, not associated with higher procedural complications, and provides a significant improvement in LV performance, symptoms, and quality of life during follow-up.
authors.affiliation: Division of Cardiology, Cardiac Arrhythmia Center and Heart Failure Unit, St. Camillo-Forlanini Hospital, Rome, and Arrhythmia Unit, St. Ambrogio's Clinical Institute, University of Milan, Italy. c.tondo@libero.it
authors.forename: Claudio
authors.initials: C
authors.lastname: Tondo
authors.forename: Massimo
authors.initials: M
authors.lastname: Mantica
authors.forename: Giovanni
authors.initials: G
authors.lastname: Russo
authors.forename: Andrea
authors.initials: A
authors.lastname: Avella
authors.forename: Lucia
authors.initials: L
authors.lastname: De Luca
authors.forename: Augusto
authors.initials: A
authors.lastname: Pappalardo
authors.forename: Rafael Lopes
authors.initials: RL
authors.lastname: Fagundes
authors.forename: Edo
authors.initials: E
authors.lastname: Picchio
authors.forename: Francesco
authors.initials: F
authors.lastname: Laurenzi
authors.forename: Vito
authors.initials: V
authors.lastname: Piazza
authors.forename: Irma
authors.initials: I
authors.lastname: Bisceglia
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000209:etiology* / Q000517:prevention & control*