Cardiology Medical News about congestive heart failure;sinus rhythm restoration;long-lasting atrial fibrillation

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Sinus rhythm restoration by catheter ablation in patients with long-lasting atrial fibrillation and congestive heart failure: impact of the left ventricular ejection fraction improvement on the implantable cardioverter defibrillator insertion indication
Europace, 06/29/09

Bortone A et al. – Atrial fibrillation ablation in congestive heart failure (CHF) pts can improve both the clinical status of patients and their left ventricular ejection fraction (LVEF) value, especially among pts affected by dilated cardiomyopathy (DCM). The LVEF improvement has the potential to preclude the indication for a primary prevention implantable cardioverter defibrillator (ICD) insertion.

Methods

Subjects: 6 CHF (mean age 61.1 ± 6.9 yrs, mean LVEF 25.8 ± 7.3%) pts refractory to conventional medical treatment with long-term AF unresponsive to external cardioversion
Idiopathic DCM in 5 pts; ischaemic cardiomyopathy (ICM) in 1 pt
NYHA class: III–IV
Renal insufficiency in 2 pts
No left ventricular delay
AF ablation for all pts

Results

LVEF and NYHA class dramatically improved in 5 DCM pts
NYHA class, but not LVEF, improved in ICM pt
Redo ablative procedure in 4 pf 5 DCM pts and in ICM pt due to arrhythmia recurrence
LVEF and NYHA improved in DCM pts, leading to ICD indication preclusion
LVEF remained low in ICM pt, leading to ICD insertion
Sinus rhythm stable during 18.1 ± 5.7 mo follow-up period

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