title: Catheter Ablation for Atrial Arrhythmias in Patients With Cardiac Amyloidosis.
abstract: Cardiac amyloidosis (CA) is associated with increased atrial arrhythmias risk. The efficacy/safety of catheter-based ablation therapy in patients with CA has not been adequately assessed.
  
  
  
  All diagnosed CA patients who underwent atrial arrhythmia ablation therapy from 1995 to 2015 were reviewed. Arrhythmia recurrence, NYHA symptoms, and mortality were recorded. A total of 26 patients with CA and atrial arrhythmias were included; there were 7 light-chain (AL), 17 wild-type transthyretin (ATTRwt), and 2 mutated transthyretin (ATTRm) amyloidosis patients in total. Of which 13 underwent atrial arrhythmia ablation (CA-A) and 13 underwent AV nodal ablation (CA-AVN). In the CA-A group, there were: 3 with atrial fibrillation (AF); 6 with atrial flutter (AFL); 2 with AF/AFL; and 2 with atrial tachycardia (AT). One-year and 3-year recurrence-free survival were 75% and 60%, respectively. NYHA symptom improvement 6 months postablation was observed in both CA-A and CA-AVN groups: 7/10 (70%) and 4/8 (50%), respectively. Eleven patients with CA died (8 in CA-AVN group vs. 3 in CA-A group).
  
  
  
  Catheter-based ablation for patients with CA appears to provide important symptomatic relief. However, mortality from the underlying disease remains a significant issue for the amyloid light-chain subtype.
authors.affiliation: Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Nicholas Y
authors.initials: NY
authors.lastname: Tan
authors.affiliation: Brody School of Medicine, East Carolina University, Greenville, North Carolina.
authors.forename: Yousef
authors.initials: Y
authors.lastname: Mohsin
authors.affiliation: Health Sciences Research, Mayo Clinic Florida, Jacksonville, Florida.
authors.forename: David O
authors.initials: DO
authors.lastname: Hodge
authors.affiliation: Department of Hematology, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Martha Q
authors.initials: MQ
authors.lastname: Lacy
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Packer
authors.affiliation: Department of Hematology, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
authors.forename: Martha
authors.initials: M
authors.lastname: Grogan
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Asirvatham
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
authors.forename: Malini
authors.initials: M
authors.lastname: Madhavan
authors.affiliation: Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota. mcleod.christopher@mayo.edu.|Department of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota, USA. mcleod.christopher@mayo.edu.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: McLEOD
mesh_terms: D000200:Action Potentials; D000368:Aged; D000686:Amyloidosis / Q000150:complications* / Q000401:mortality; D001281:Atrial Fibrillation / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001282:Atrial Flutter / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D009202:Cardiomyopathies / Q000150:complications* / Q000401:mortality; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006325:Heart Atria / Q000503:physiopathology / Q000601:surgery*; D006339:Heart Rate; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013617:Tachycardia, Supraventricular / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: AV junctional ablation; atrial fibrillation; atrial flutter; atrial tachycardia; cardiac amyloidosis; catheter ablation; pacemaker