Catheter ablation for atrial fibrillation in patients with congestive heart failure
Catheter ablation for atrial fibrillation in patients with congestive heart failure
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DOI：
10.1016/j.ijcard.2021.02.060
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发表时间：
2021-05-04
影响因子：
3.5
通讯作者：
Sasano, Tetsuo
中科院分区：
文献类型：
--
作者：
Nitta, Giichi;Inaba, Osamu;Sasano, Tetsuo
背景：我们评估了伴有或不伴有充血性心力衰竭（CHF）的心房颤动（AF）患者在导管消融（CA）后1年维持窦性心律的成功率。方法：在这项单中心回顾性配对队列研究中，对2012年1月至2018年6月期间接受首次CA治疗的3018例房颤患者进行了研究，其中227对（CHF组）或未（CHF组）患者进行了倾向评分匹配。在CHF组，108例患者被分配到心律失常性心肌病（AIC）组，其左室收缩功能障碍仅由持续房颤或房性心动过速解释；其余119例为器质性心脏病（非aic组）。我们评估了ca前后1年无af生存期和临床表现变化。结果：CHF组和对照组无af生存期相似；然而，AIC患者的生存期明显优于非AIC患者。房颤复发与CHF再住院显著相关，非AIC组的房颤复发明显高于AIC组。两组患者CA前后左心扩张、脑钠肽水平、左室射血功能等临床指标均有明显改善。AIC组的改善程度明显优于非AIC组。结论：CHF组与对照组1年成功率无显著性差异。AIC组1年成功率与AIC对照组相似，优于非AIC组。CHF临床转归明显改善。(c) 2021年Elsevier B.V.出版
Background: We evaluated the 1-year success rate of maintaining sinus rhythm after catheter ablation (CA) for atrial fibrillation (AF) in patients with or without congestive heart failure (CHF).Methods: In this single-centre retrospective matched-pair cohort study of 3,018 AF patients who underwent initial CA between January 2012 and June 2018, 227 pairs with (CHF group) or without CHF (control group) were matched using propensity scores. In the CHF group, 108 patients were assigned to the arrhythmia-induced cardiomyopathy (AIC) group whose left ventricular systolic dysfunction was explained only by lasting AF or atrial tachycardia; the remaining 119 had organic heart diseases (non-AIC group). We evaluated the 1-year AF-free survival and changes in clinical findings before and after CA.Results: The CHF and control groups showed similar AF-free survival; however, AIC patients had significantly better survival than non-AIC patients. AF recurrence was significantly related to CHF re-hospitalisation, which was significantly more frequent in the non-AIC group than in the AIC group. The clinical outcomes of left atrial dilation, brain natriuretic peptide level, and left ventricular ejection function improved significantly before and after CA in both groups. The degree of improvement was significantly better in the AIC group than in the nonAIC group.Conclusions: The 1-year success rate was not significantly different between the CHF and control groups. The 1 year success rate in the AIC group was similar to that in the AIC-control group and was better than that in the non-AIC group. CHF clinical outcomes were improved significantly.(c) 2021 Published by Elsevier B.V.