scholarly journals Recurrences of atrial fibrillation in patients with heart failure without reduced ejection fraction: a role for CA125

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J A Perez Rivera ◽  
A Merino-Merino ◽  
R Saez-Maleta ◽  
S Gundin-Menendez
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Ejection Fraction ◽  
Sinus Rhythm ◽  
Myocardial Damage ◽  
Clinical Severity ◽  
Reduced Ejection Fraction ◽  
Funding Sources ◽  
Clinical Instability ◽  
Sinus Rhythm Maintenance

Abstract Background Atrial fibrillation (AF) and heart failure (HF) without reduced ejection fraction often occur together, and their combination is associated with increased morbidity and mortality compared with each disorder alone. Sinus rhythm maintenance seems to be beneficial but challenging in these patients. Purpose We studied the possible value of CA125 to predict recurrences in patients with persistent AF and HF without reduced ejection fraction who underwent electrical cardioversion (ECV). Methods We designed a prospective cohort study by consecutively including all the patients who underwent ECV in our hospital with symptomatic persistent non-valvular AF and a concomitant diagnosis of HF without reduced ejection fraction. We excluded patients with clinical instability or ejection fraction <40%. We defined HF as the presence of diastolic dysfunction in echo (left atrium indexed volume >34 ml/m2 or e/e' >8) or ejection fraction between 40 and 50%. We followed-up them during 6 months for detecting AF recurrences with an ECG-Holter 3 months after ECV and an ECG at 6th month. We considered a recurrence as any AF documentation in ECG or ECG-Holter after the ECV. A peripheral blood sample was extracted just before ECV and CA125 was determined. Kaplan-Meyer analysis was used to study the possible relationship between CA125 plasmatic levels, dichotomized according to the median value, and AF recurrence. Results We included 95 patients with a medium age of 64±9 years old. Of them, 31 (32.6%) were women, 14 (14.7%) had diabetes and 56 (58.9%) hypertension. The medium ejection fraction was 58.14±10.27% and the median CA125 was 10.98±8.97 U/ml. We detected 54 (57.4%) recurrences in 6 months. In patients with AF recurrences, CA125 values were higher than in patients who maintained sinus rhythm (19.28±29.11 U/ml vs. 14.98±17.02 U/ml). CA125 was significantly related with AF recurrences (log-rank 5.37; p=0.021). Conclusions In our sample of patients with persistent AF and HF without reduced ejection fraction, CA125 plasmatic levels are related with AF recurrences after ECV. CA125 has been associated with the clinical severity of HF and the symptoms and signs of fluid congestion. This probably means more ventricular and atrial myocardial damage that might predispose to AF. Sinus rhythm maintenance is specially challenging in patients with HF so those with higher levels of CA125 probably need a closer surveillance and a more aggressive rhythm control. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Heart rate and outcome in heart failure with reduced ejection fraction: Differences between atrial fibrillation and sinus rhythm—A CIBIS II analysis

2017 ◽  
Vol 40 (9) ◽  
pp. 740-745 ◽  
Author(s):  
Bart A. Mulder ◽  
Kevin Damman ◽  
Dirk J. Van Veldhuisen ◽  
Isabelle C. Van Gelder ◽  
Michiel Rienstra
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Rate ◽  
Ejection Fraction ◽  
Sinus Rhythm ◽  
Reduced Ejection Fraction

scholarly journals Relationship between heart rate and outcomes in patients in sinus rhythm or atrial fibrillation with heart failure and reduced ejection fraction

2019 ◽  
Vol 22 (3) ◽  
pp. 528-538 ◽  
Author(s):  
Kieran F. Docherty ◽  
Li Shen ◽  
Davide Castagno ◽  
Mark C. Petrie ◽  
William T. Abraham ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Rate ◽  
Ejection Fraction ◽  
Sinus Rhythm ◽  
Reduced Ejection Fraction

scholarly journals B-PO03-114 ATRIAL FIBRILLATION AND HEART FAILURE WITH PRESERVED VERSUS REDUCED EJECTION FRACTION: OUTCOMES AFTER CATHETER ABLATION

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S235
Author(s):  
Amrita Krishnamurthy ◽  
Parag Goyal ◽  
Steven M. Markowitz ◽  
Christopher F. Liu ◽  
George Thomas ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Ejection Fraction ◽  
Reduced Ejection Fraction

scholarly journals Prognostic value of atrial fibrillation in patients with heart failure and different left ventricular ejection fraction: results of the multicenter RIF-CHF register

2021 ◽  
Vol 26 (1) ◽  
pp. 4200
Author(s):  
I. V. Zhirov ◽  
N. V. Safronova ◽  
Yu. F. Osmolovskaya ◽  
S. N. Тereschenko
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Ejection Fraction ◽  
Cardiovascular Mortality ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Number Of Patients ◽  
Increased Risk

Heart failure (HF) and atrial fibrillation (AF) are the most common cardiovascular conditions in clinical practice and frequently coexist. The number of patients with HF and AF is increasing every year.Aim. To analyze the effect of clinical course and management of HF and AF on the outcomes.Material and methods. The data of 1,003 patients from the first Russian register of patients with HF and AF (RIF-CHF) were analyzed. The endpoints included hospitalization due to decompensated HF, cardiovascular mortality, thromboembolic events, and major bleeding. Predictors of unfavorable outcomes were analyzed separately for patients with HF with preserved ejection fraction (AF+HFpEF), mid-range ejection fraction (AF+HFmrEF), and reduced ejection fraction (AF+HFrEF).Results. Among all patients with HF, 39% had HFpEF, 15% — HFmrEF, and 46% — HFrEF. A total of 57,2% of patients were rehospitalized due to decompensated HF within one year. Hospitalization risk was the highest for HFmrEF patients (66%, p=0,017). Reduced ejection fraction was associated with the increased risk of cardiovascular mortality (15,5% vs 5,4% in other groups, p<0,001) but not ischemic stroke (2,4% vs 3%, p=0,776). Patients with HFpEF had lower risk to achieve the composite endpoint (stroke+MI+cardiovascular death) as compared to patients with HFmrEF and HFrEF (12,7% vs 22% and 25,5%, p<0,001). Regression logistic analysis revealed that factors such as demographic characteristics, disease severity, and selected therapy had different effects on the risk of unfavorable outcomes depending on ejection fraction group.Conclusion. Each group of patients with different ejection fractions is characterized by its own pattern of factors associated with unfavorable outcomes. The demographic and clinical characteristics of patients with mid-range ejection fraction demonstrate that these patients need to be studied as a separate cohort.

scholarly journals Predictors for early mortality in patients with implantable cardiac defibrillator for heart failure with reduced ejection fraction

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
G Cinier ◽  
MI Hayiroglu ◽  
L Pay ◽  
AC Yumurtas ◽  
O Tezen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Multivariate Analysis ◽  
Ejection Fraction ◽  
Blood Urea Nitrogen ◽  
Cox Regression ◽  
Nyha Class ◽  
Urea Nitrogen ◽  
Reduced Ejection Fraction ◽  
Device Implantation

Abstract Funding Acknowledgements Type of funding sources: None. Background Implantable cardiac defibrillators (ICD) are recommended in heart failure with reduced ejection fraction (HFrEF) patients to reduce arrhythmic deaths. The only contraindication for not implanting ICD is life expectancy of less than 1 year. We aimed to identify risk factors associated with mortality within 1 year following the device implantation. Methods Data from our hospital’s electronic database system was extracted for patients who were implanted ICD secondary to HFrEF between 2009 and 2019. Those who died within 1 year following the device implantation were analyzed in the present paper. Multiple Cox regression analysis using the backward logistical regression method was applied to determine the best predictors that affect 1-year mortality Results Overall 1107 patients were included in the present analysis. ICD was implanted in 77.2% and 22.8% for ischemic and non-ischemic HFrEF respectively. Mortality rate at 1-year following the device implantation was 4.7%. In multivariate analysis age [Hazard ratio (HR), 1.04; Confidence 95% Intervals (CI), 1.02 – 1.06; P = 0.001], atrial fibrillation (AF) (HR, 4.12; 95% CI, 2.34 – 7.24, P &lt; 0.001), NYHA class &gt; 2 symptoms (HR, 5.33; 95% CI, 2.92 – 9.73, P &lt; 0.001), blood urea nitrogen (BUN) (HR, 1.02; 95% CI, 1.00 – 1.03, P = 0.03) and albumin (HR, 0.52; 95% CI, 0.34 – 0.80, P = 0.003) independently predicted 1-year mortality Conclusion In patients with HFrEF and implanted ICD, older age, presence of AF and NYHA class &gt; II symptoms, elevated BUN and reduced albumin levels predicted 1-year mortality. Table 1 Multivariate analysis P value HR (95% CI) Age 0.001 1.038 (1.015 - 1.062) Atrial fibrillation &lt;0.001 4.119 (2.342 - 7.241) NYHA &gt; 2 &lt;0.001 5.328 (2.917 - 9.731) Blood urea nitrogen 0.034 1.017 (1.001- 1.034) Albumin 0.003 0.520 (0.337 - 0.801) Multivariate Cox regression analyses for 1-year mortality after implantation

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