title: Congestive heart failure after extensive catheter ablation for atrial fibrillation: prevalence, characterization, and outcome.
abstract: BACKGROUND
  This study sought to describe a new complication of catheter ablation for atrial fibrillation (AF): new onset congestive heart failure (CHF) after extensive ablation for AF.
  
  
  RESULTS
  Data from 12 patients developing CHF after ablation were prospectively collected. All patients underwent extensive ablation for AF including circumferential pulmonary venous ablation and complex fractionated atrial electrograms guided ablation. CHF was diagnosed using the following criteria: symptoms or signs of heart failure, elevated BNP, and echocardiographic evidence of left ventricular diastolic dysfunction. Twelve patients (5 persistent and 7 permanent AF) had CHF after extensive ablation out of 484 consecutive AF patients who underwent catheter ablation (prevalence 2.5%). None of these 12 patients had CHF prior to the procedure. The mean onset of the symptoms was 39 ± 14 hours after the index procedure. Dyspnea and pulmonary rales were the most observed symptoms or signs. White blood cell count, serum CRP, BNP, and echocardiographic parameters of left ventricular diastolic dysfunction (E/A, E/E') were significantly increased after the onset of symptoms. All patients had complete recovery with supportive therapy within 3 days of the onset of symptoms.
  
  
  CONCLUSIONS
  In this single-center experience, CHF after extensive ablation for AF was a well-recognized complication with a relatively high incidence of 2.5%. Measurement of BNP, CRP, and E/A, E/E' is useful in managing these patients.
authors.affiliation: Department of Cardiology, Shanghai Chest Hospital affiliated to Shanghai Jiaotong University, Shanghai, China.
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Tan
authors.forename: Xin-Hua
authors.initials: XH
authors.lastname: Wang
authors.forename: Hai-Feng
authors.initials: HF
authors.lastname: Shi
authors.forename: Yu-Ming
authors.initials: YM
authors.lastname: Sun
authors.forename: Li
authors.initials: L
authors.lastname: Zhou
authors.forename: Jia-Ning
authors.initials: JN
authors.lastname: Gu
authors.forename: Bing
authors.initials: B
authors.lastname: Han
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Jiang
authors.forename: Guo-Shu
authors.initials: GS
authors.lastname: Yang
authors.forename: Xu
authors.initials: X
authors.lastname: Liu
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000601:surgery*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D015897:Comorbidity; D005858:Germany / Q000453:epidemiology; D006333:Heart Failure / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors