Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Trajanoski, D.
Catheter ablation in patients with atrial fibrillation and reduced ejection fraction.
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2020. pp. 63
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Manninger-Wünscher Martin
- Scherr Daniel
- Altmetrics:
- Abstract:
- Introduction Atrial fibrillation (AF) is the most common arrhythmia in adults, with catheter ablation being an established second-line therapy. AF frequently occurs in patients with heart failure (HF) and leads to a worse prognosis. Conversely, HF with reduced ejection fraction (HFrEF) has been proposed as a predictor of poorer outcome in catheter ablation procedures. Therefore, this thesis aimed to investigate the long-term outcome of patients with HFrEF undergoing AF catheter ablation. Methods Patients undergoing AF catheter ablation at the University Hospital of Graz were assigned to one of two groups according to their left ventricular systolic function (LVEF). Relevant patient data was collected retrospectively in a registry from 2011 until 2018. Success was defined as AF and atrial tachycardia free survival during follow up. Rhythm was monitored at 3- and 12-months following the procedure by means of 24-hour Holter ECG monitoring. Results 274 patients were included in the analysis. 243 patients had normal left ventricular function (nEF, 64±5%), while 31 patients had reduced systolic function (rEF, 49±10%). Baseline characteristics were largely comparable, though atrial enlargement was more frequent in rEF patients (48 vs. 25%, P=0.005). Single procedure success rate was 59% in nEF patients and 67% in rEF patients (log rank test: P=0.203) after a follow-up duration of 340 (122, 555) vs. 192 (107, 452) days (P=0.12). Complication rate was low in both study cohorts. Repeat ablations were performed in 19 vs. 23% of patients (P=0.17). Discussion There was no significant difference in outcome and complication rate between the nEF and rEF group. Therefore, it can be concluded that catheter ablation is reasonable and safe for the treatment of AF in patients with HFrEF.