医学
心脏病学
内科学
射血分数
心房颤动
窦性心律
心力衰竭
导管消融
利钠肽
脑利钠肽
阵发性心房颤动
烧蚀
作者
Ryota Yamauchi,Itsuro Morishima,Kenji Okumura,Yasunori Kanzaki,Yasuhiro Morita,Kensuke Takagi,Hiroto Nagai,Naoki Watanabe,Koichi Furui,Naoki Yoshioka,Hiroyuki Miyazawa,Kazuki Shimojo,Takuro Imaoka,Gaku Sakamoto,Toyoaki Murohara
出处
期刊:Europace
[Oxford University Press]
日期:2021-03-10
卷期号:23 (8): 1252-1261
被引量:11
标识
DOI:10.1093/europace/euaa420
摘要
We aimed to examine the benefits of catheter ablation in patients with non-paroxysmal atrial fibrillation (AF) accompanied by heart failure (HF) with preserved ejection fraction (HFpEF), in comparison with the benefits in patients with AF accompanied by HF with reduced ejection fraction (HFrEF) or patients with no HF.From 1173 consecutive patients undergoing catheter ablation, 502 with non-paroxysmal AF were divided into three groups: no history of HF [plasma B-type natriuretic peptide (BNP) <100 pg/mL and no HF hospitalization; n = 125], HFpEF [left ventricular (LV) EF ≥50%; n = 293], and HF with midrange EF (HFmrEF) + HFrEF (LVEF <50%; n = 84) groups. The endpoints were AF recurrence at 1 year, changes in symptomatic and image-based functional status, and changes in BNP levels from baseline to 1 year. In the HFpEF group, AF recurred in 48 patients (16.4%) and 278 patients (94.8%) had sinus rhythm at 1 year; these values were comparable with those in the other groups. Significant improvement was observed in the left atrial diameter, LVEF, and New York Heart Association functional class in the HFpEF and HFmrEF + HFrEF groups. The BNP level significantly decreased irrespective of the index rate control status, and freedom from AF recurrence was an independent predictor of HF remission, defined as BNP <100 pg/mL at 1 year, in the HFpEF group.Catheter ablation is highly feasible for restoring sinus rhythm in non-paroxysmal AF with coexisting HFpEF, thereby improving cardiac function and BNP levels. Catheter ablation for AF may be an optional management strategy.
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