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Catheter ablation for patients with atrial fibrillation and tachycardia induced cardiomyopathy
Session:
Posters 5 - Écran 4 - Arritmologia
Speaker:
Joana Ribeiro
Congress:
CPC 2019
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.4 Atrial Fibrillation - Treatment
Session Type:
Posters
FP Number:
---
Authors:
Joana M. Ribeiro; Pedro Sousa; Rogerio Teixeira; Luís Puga; Alexandrina Siserman; José Pedro Sousa; Carolina Saleiro; Diana Decampos; Luis Elvas; Lino Gonçalves
Abstract
<p><strong>Introduction and objectives:</strong> Catheter ablation (CA) for atrial fibrillation (AF) has been shown to improve outcomes in patients with heart failure (HF) with reduced ejection fraction. We aimed to assess the impact of CA for AF in the subset of patients with tachycardia induced cardiomyopathy (TIC).</p> <p><strong>Methods</strong>: Cohort analysis of all patients subjected to CA for AF due to TIC. We included in the study patients with a left ventricle ejection fraction (LVEF) <50[J1] %, while in AF, with no other apparent cause for systolic dysfunction. The primary endpoint was improvement in LVEF and the secondary endpoint was need for antiarrhythmic drugs after CA.</p> <p><strong>Results</strong>: Our population consisted of 19 patients, mostly male (78%) with a median age of 60 years (interquartile range (IQR) 52-68). Median follow-up time was 9 months (IQR 4.2-11.8). Median LVEF while in AF was 40% (IQR 35-40) and median New York Heart Association at baseline was 2 (IQR 2-2.25). Thirty-two per cent of the patients presented with paroxysmal AF, while the remaining 68% had persistent AF. Mean time from AF diagnosis to CA was 4 years (IQR 2.5-7.5) and 79% of the patients had been subjected to at least one electrical cardioversion. Before CA 79% of patients were medicated with antiarrhythmic drugs, while the remaining had a formal contraindication to all antiarrhythmic drugs or did not tolerate such therapy.</p> <p>At the beginning of the procedure, 53% of the patients were in sinus rhythm. Pulmonary vein isolation was performed in all patients, and additional ablation points were necessary in 32%. Whenever AF persisted or was induced at the end of the procedure, electrical cardioversion was performed (53%). One procedure-related complication (post-procedural pericarditis, without the need for hospital admission) occurred in one patient.</p> <p>Overall AF recurrence during follow-up was 32%, while AF recurrence after the first 3 months was 29%. AF was recurrent only in patients initially presenting with persistent AF. At last follow-up 56% of the patients were free of antiarrhythmic drugs. Median LVEF improved from 40% (IQR 35-30) to 57% (IQR 55-61[C2] , <em>P</em><0.01) and 94% reported improvement of symptoms.</p> <p><strong>Conclusion</strong>: Our results showed that catheter ablation for atrial fibrillation in patients with tachycardia induced cardiomyopathy improves left ventricle ejection fraction, while reducing the need for antiarrhythmic medication. However, our cohort is very small, and this data requires further validation.</p> <p> </p>
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