title: Catheter ablation of atrial fibrillation in patients with severely impaired left ventricular systolic function.
abstract: Little is known about the outcome of catheter ablation of atrial fibrillation (AF) in patients with heart failure (HF) and a severely reduced left ventricular ejection fraction (LVEF). We aimed to clarify the effectiveness of catheter ablation of AF in patients with a severely low LVEF. This retrospective study included 18 consecutive patients with HF and an LVEF of ≤ 35 % who underwent catheter ablation of AF. We investigated the clinical parameters, echocardiographic parameters and the incidence of hospitalizations for HF. During a median follow-up of 21 months (IQR, 13-40) after the final procedure (9 with repeat procedures), 11 patients (61 %) maintained sinus rhythm (SR) (6 with amiodarone). The LVEF and NYHA class significantly improved at 6 months after the CA in 12 patients (67 %) who were in SR or had recurrent paroxysmal AF (from 25.8 ± 6.3 to 37.0 ± 11.7 %, P = 0.02, and from 2.3 ± 0.5 to 1.5 ± 0.7, P < 0.01, respectively) but not in patients who experienced recurrent persistent AF. The patients with SR or recurrent paroxysmal AF had significantly fewer hospitalizations for HF than those with recurrent persistent AF after the AF ablation (log-rank test; P < 0.01). Catheter ablation of AF improved the clinical status in patients with an LVEF of ≤ 35 %. A repeat ablation procedure and amiodarone were often necessary to obtain a favorable outcome.
authors: Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors: Ken
authors: K
authors: Kato
authors: Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. koichiro@qf6.so-net.ne.jp.
authors: Koichiro
authors: K
authors: Ejima
authors: Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.|Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan.
authors: Noritoshi
authors: N
authors: Fukushima
authors: Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.|Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University School of Medicine, Takamatsu, Kagawa, Japan.
authors: Makoto
authors: M
authors: Ishizawa
authors: Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.|Department of Cardiology, Oita Medical Center, Oita, Japan.
authors: Osamu
authors: O
authors: Wakisaka
authors: Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors: Ryuta
authors: R
authors: Henmi
authors: Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors: Kentaro
authors: K
authors: Yoshida
authors: Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors: Toshiaki
authors: T
authors: Nuki
authors: Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors: Kotaro
authors: K
authors: Arai
authors: Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.|Department of Cardiology, Sendai Cardiovascular Center, Sendai, Miyagi, Japan.
authors: Bun
authors: B
authors: Yashiro
authors: Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors: Tetsuyuki
authors: T
authors: Manaka
authors: Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors: Kyomi
authors: K
authors: Ashihara
authors: Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors: Morio
authors: M
authors: Shoda
authors: Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors: Nobuhisa
authors: N
authors: Hagiwara
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013599:Systole; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: Atrial fibrillation; Catheter ablation; Heart failure; Pulmonary vein isolation; Systolic dysfunction
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