scholarly journals Erratum to: Left atrial fibrosis predicts left ventricular ejection fraction response after atrial fibrillation ablation in heart failure patients: the Fibrosis-HF Study

EP Europace ◽  
2020 ◽  
Vol 22 (12) ◽  
pp. 1821-1821
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Left Ventricular Ejection Fraction ◽  
Left Atrial ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Atrial Fibrosis ◽  
Ventricular Ejection Fraction ◽  
Heart Failure Patients ◽  
Left Atrial Fibrosis

Left atrial fibrosis predicts left ventricular ejection fraction response after atrial fibrillation ablation in heart failure patients: the Fibrosis-HF Study

EP Europace ◽  
2020 ◽  
Vol 22 (12) ◽  
pp. 1812-1821
Author(s):  
Bettina Kirstein ◽  
Sebastian Neudeck ◽  
Thomas Gaspar ◽  
Judith Piorkowski ◽  
Simon Wechselberger ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Ejection Fraction ◽  
Left Atrial ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Atrial Fibrosis ◽  
Ventricular Ejection Fraction ◽  
Af Ablation ◽  
Left Atrial Fibrosis

Abstract Aims Atrial fibrillation (AF) and heart failure (HF) often coexist. Catheter ablation has been reported to restore left ventricular (LV) function but patients benefit differently. This study investigated the correlation between left atrial (LA) fibrosis extent and LV ejection fraction (LVEF) recovery after AF ablation. Methods and results In this study, 103 patients [64 years, 69% men, 79% persistent AF, LVEF 33% interquartile range (IQR) (25–38)] undergoing first time AF ablation were investigated. Identification of LA fibrosis and selection of ablation strategy were based on sinus rhythm voltage mapping. Continuous rhythm monitoring was used to assess ablation success. Improvement in post-ablation LVEF was measured as primary study endpoint. An absolute increase in post-ablation LVEF ≥10% was defined as ‘Super Response’. Left atrial fibrosis was present in 38% of patients. After ablation LVEF increased by absolute 15% (IQR 6–25) (P < 0.001). Left ventricular ejection fraction improvement was higher in patients without LA fibrosis [15% (IQR 10–25) vs. 10% (IQR 0–20), P < 0.001]. An inverse correlation between LVEF improvement and the extent of LA fibrosis was found (R2 = 0.931). In multivariate analysis, the presence of LA fibrosis was the only independent predictor for failing LVEF improvement [odds ratio 7.2 (95% confidence interval 2.2–23.4), P < 0.001]. Echocardiographic ‘Super Response’ was observed in 55/64 (86%) patients without and 21/39 (54%) patients with LA fibrosis, respectively (P < 0.001). Conclusion Presence and extent of LA fibrosis predict LVEF response in HF patients undergoing AF ablation. The assessment of LA fibrosis may impact prognostic stratification and clinical management in HF patients with AF.

Abstract 2156: Left Atrial Fibrosis Impacts Left Ventricular Ejection Fraction in Patients with Atrial Fibrillation

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Nazem W Akoum ◽  
Robert S Oakes ◽  
Yaw Adjei-Poku ◽  
Suman Kuppahally ◽  
Nathan M Segerson ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Lv Function ◽  
Atrial Fibrosis ◽  
Ventricular Ejection Fraction ◽  
Average Improvement ◽  
Left Atrial Fibrosis

Background. The extent of left atrial (LA) wall fibrosis detected by delayed enhancement MRI (DE-MRI) appears to be correlated with advanced atrial fibrillation (AF). However, the effect of LA fibrosis on left ventricular function (LVEF) is not well understood. We report the relationship between left atrial fibrosis and LVEF in patients with AF. Methods. Sixty-seven patients underwent DE-MRI and 2-dimensional trans-thoracic echocardiography prior to ablation for AF. Three dimensional segmentation of the LA was performed and the extent of fibrosis was quantified using a semi-automated algorithm. Patients were assigned to one of three groups based on the degree of LA fibrosis; 1) mild enhancement where the fibrosis < 15% of the LA wall, 2) moderate enhancement where fibrosis > 15% and < 35%, and extensive where fibrosis > 35% of the LA wall. LVEF was determined both prior to and 3 months following pulmonary vein antrum isolation with posterior wall and septal debulking. Results. The average pre-ablation LVEF among patients with mild fibrosis was 53.2% ± 9.9% (n = 41), 52.3% ± 7.4% (n = 19) among patients with moderate fibrosis and 42.1% ± 9.9% (n = 7) among those with extensive enhancement (p = 0.01,one way ANOVA). The difference remains significant after controlling for patient age, gender, hypertension, MI, AF type, mitral valve regurgitation, CAD and the presence of non-AF related CHF. Following ablation, all groups had an increase in the LVEF. The greatest increase occurred among patients in the extensive group. On average, this group experienced an overall improvement of 10.8% ± 14.1%. Patients in the mild enhancement group had an average improvement of 3.3% ± 11.1% and those in the moderate group had an average improvement of 3.8% ± 5.6%. The post-ablation LVEF among patients with mild fibrosis was 56.6% ± 8.3%, 56.2% ± 6.4% among patients with moderate fibrosis and 53.0% ± 15.4% among patients with extensive fibrosis. Conclusion. From our preliminary experience with DE-MRI fibrosis detection, patients with extensive LA fibrosis appear to have depressed LV function pre-ablation. This group of patients seems to experience a large improvement (~11%) in LV function post-ablation compared to patients with less LA fibrosis.

Predictive value of atrial fibrillation catheter ablation on cognitive functions in patients with chronic heart failure

2021 ◽  
Vol 42 (2) ◽  
pp. 75-81
Author(s):  
T. V. Zolotarova ◽  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cognitive Function ◽  
Catheter Ablation ◽  
Chronic Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Cognitive Functions ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Atrial fibrillation (AF) directly leads to a cognitive function decline regardless of the cerebrovascular fatal events, but it is unclear whether the sinus rhythm restoration and reducing the AF burden can reduce the rate of this decreasement. Data on the effect of radiofrequency ablation on patients’ cognitive functions are conflicting and need to be studied. The aim of the study was to evaluate the prognostic value of atrial fibrillation radiofrequency catheter ablation on cognitive functions in patients with chronic heart failure with preserved left ventricular ejection fraction. The impact of AF radiofrequency catheter ablation on cognitive function in 136 patients (mean age 59.7 ± 8.6 years) with chronic heart failure with preserved left ventricular ejection fraction and compared with 58 patients in the control group (58.2 ± 8.1 years), which did not perform ablation and continued the tactics of drug antiarrhythmic therapy was investigated. Cognitive function was assessed using the Montreal Cognitive Test (MoCA) at the enrollment stage and 2 years follow-up. Decreased cognitive function was defined as a MoCA test score < 26 points, cognitive impairment < 23 points. Two years after the intervention, there was a positive dynamics (baseline MoCA test — 25,1 ± 2,48, 2-year follow-up — 26,51 ± 2,33, p < 0,001) in the ablation group and negative in the control group (25,47 ± 2,85 and 24,57 ± 3,61, respectively, p < 0,001). Pre-ablation cognitive impairment was significantly associated with improved cognitive function 2 years after AF ablation according to polynomial regression analysis. The obtained data suggest a probable positive effect of AF radiofrequency ablation on cognitive functions in patients with preserved left ventricular ejection fraction.

Sign in / Sign up

Export Citation Format

Share Document