scholarly journals Radiofrequency ablation in treatment of atrial fibrillation

2010 ◽  
pp. S43-S49
Author(s):  
R Lábrová ◽  
J Špinar ◽  
N Honzíková
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Metabolic Syndrome ◽  
Radiofrequency Ablation ◽  
Catheter Ablation ◽  
Left Ventricle ◽  
Sinus Rhythm ◽  
21St Century ◽  
Effective Therapy ◽  
Morbidity And Mortality

Beside heart failure and metabolic syndrome, atrial fibrillation is termed the cardiovascular epidemic of the 21st century. Its increased morbidity and mortality is alarming. The present, most effective therapy of atrial fibrillation is catheter ablation. Successful ablation of atrial fibrillation prevents the occurrence and progression of electrical, structural and mechanic myocardium remodelling, improves function of the left ventricle, and prevents the risk of thrombembolism. Onset of sinus rhythm activates the reversal remodelling leading to wall reconstruction and atrium reduction. The paper reviews the technique and presents own experience with catheter ablation.

Abstract 17223: Castle of Stone or Straw, Radiofrequency Ablation of Atrial Fibrillation in Heart Failure?

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Brian D McCauley ◽  
Esseim Sharma ◽  
John Dudley ◽  
Antony Chu
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Sinus Rhythm ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Prospective Trials

Introduction: Based on the data from CASTLE-AF trial, in patient with Atrial Fibrillation (AF) and heart failure (HF) catheter ablation may offer a significant reduction in both death, and hospitalization, while promoting maintenance of sinus rhythm as well as improvement in left ventricular ejection fraction (LVEF). This multi-center randomized trial is hailed as a paradigm shifting study in catheter ablation, however it is not without fault. One of the critiques of the CASTLE-AF trial was the high frequency of crossover between the treatment arms. To help sort out this potential source of confounding, we performed a systematic meta-analysis of prospective trials for catheter ablation in AF in patients with Class II through IV heart failure. Hypothesis: The reduction in death, and hospitalization, as well as the maintenance in sinus rhythm and improvement in LVEF seen CASTLE-AF trial are support by other similarly designed AF ablation trials. Methods: Using the inclusion/exclusion criteria from the CASTLE-AF trial, we performed a systematic meta-analysis of 28 published studies. Randomized and non-randomized observational studies comparing the impact of catheter ablation of AF in HF. Studies were identified using the Cochrane Library, EMBASE, and PubMed. Results: A total of 29 studies were identified (n =2,339). Mean follow-up was 25 (95% confidence interval, 18-40) months. Efficacy in maintaining sinus rhythm at follow-up end was 60% (43%-76%). Left ventricular ejection fraction improved significantly during follow-up by 15% (P<0.001). Conclusions: Following our meta-analysis, we found data to support the findings of improved LVEF and maintenance of sinus rhythm reported in the CASTLE-AF trial. However, due to differences in study design, we were unable to further validate the reduction in both hospitalization and death seen in CASTLE-AF. We recommend future prospective trials be conducted without cross over to further explore this topic.

scholarly journals Atrial fibrillation promotion in a rat model of heart failure induced by left ventricle radiofrequency ablation

2018 ◽  
Vol 21 ◽  
pp. 22-28 ◽  
Author(s):  
Luis dos Santos ◽  
Ednei L. Antonio ◽  
Andrey J. Serra ◽  
Amanda Yoshizaki ◽  
Larissa Seibt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Left Ventricle ◽  
Rat Model

scholarly journals Outcomes of heart failure with preserved ejection fraction after radiofrequency catheter ablation for atrial fibrillation

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
T Zolotarova ◽  
M Brynza ◽  
O Bilchenko
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Control Strategy ◽  
Rate Control ◽  
Left Ventricle Ejection Fraction ◽  
Preserved Ejection Fraction

Abstract Funding Acknowledgements Type of funding sources: None. Introduction. Recent randomized controlled trials have shown that in heart failure (HF) patients with reduced left ventricle ejection fraction (HFrEF) atrial fibrillation (AF) ablation reduces hospitalization and mortality due to HF compared to medical therapy (MT). However, only few studies have examined outcomes of catheter ablation (CA) for AF in HF patients with preserved left ventricle ejection fraction (HFpEF).  Purpose. To compare the effect of catheter ablation on the outcomes of atrial fibrillation with chronic heart failure with preserved ejection fraction. Methods. Our prospective study included the main group (136 patients with the HFpEF who underwent a single procedure of the CA for symptomatic AF) and control group (58 patients with the HFpEF patients with paroxysmal or persistent AF on MT for rhythm and rate control strategy). To be eligible for inclusion for both groups, left ventricular diastolic dysfunction had to be present and/or relevant structural heart disease according to the current guidelines had to be fulfilled within 6 months prior to AF ablation. Outpatient follow-up were performed at 6, 12, 24 months intervals thereafter baseline.  Results. At the follow-up the composite primary end point (all-cause death or worsening of HF that led to an unplanned hospitalization) appeared in significantly fewer patients in the CA group than in the MT group (18 (13,2%) patients vs. 16 (27,5%) patients; p =0,005). The secondary analyses showed there was 5 deaths in the CA group and 2 deaths in MT group, with rate of 3,7%  and 3,4% respectively that were equal in comparable groups (p = 0,362). The incidences of HF hospitalization and cardiovascular hospitalization were also significantly higher in MT group than in CA group (14 (24,1%) vs. 13 (9,6%), p = 0,005) vs. 21 (15,4%), p = 0,016, respectively). Cardiovascular death and cerebrovascular accident were equal in comparable groups. The Kaplan–Meier curve for primary end-point demonstrated significant higher survival and freedom from hospitalizations due to HF in the CA group compared to MT group (p = 0,005); the freedom from hospitalization for worsening HF and the freedom from the cardiovascular hospitalization were having higher probability in the СA group (p = 0,003 and p= 0,016 ). Conclusion. Comparing catheter ablation with medical therapy for rhythm or rate control strategy in patients with heart failure with preserved left ventricle ejection fraction and atrial fibrillation, we found that catheter ablation was associated with lower rate of deaths and hospitalization due to worsening of heart failure.

scholarly journals PARAMETERS OF THE HEMODYNAMIC AFTER ABLATION ATRIAL FIBRILLATION AND/OR FLUTTER DEPENDING ON THE FUNCTIONAL CLASS OF CHRONIC HEART FAILURE

2018 ◽  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Chronic Heart Failure ◽  
Left Ventricle ◽  
Left Atrium ◽  
Independent Predictor ◽  
Functional Class ◽  
Acute Period ◽  
Left Atrium Size

Evaluated parameters of the hemodynamic before and after ablation atrial fibrillation and/or flutter depending on the functional class of chronic heart failure in 74 patients. It was found that patients with the I functional class of chronic heart failure have significantly lower left atrium size compared to III functional class, which is associated with the better efficiency of the radiofrequency ablation in the remote period. Patients with the I and III functional class of chronic heart failure are having increasement of QTc duration in acute period of radiofrequency ablation that could be used as an independent predictor of arrhythmia recurrence. Patients with the I functional class chronic heart failure who failed drug therapy for atrial fibrillation and/or flutter alternative treatment in the form of the radiofrequency ablation should be considered as choice therapy. The levels of heart rate and pulse decreases in I and III functional class of the chronic heart failure in the acute period radiofrequency ablation; systolic and diastolic blood pressure, QRS, left ventricle end-diastolic and left ventricle end-systolic diameter do not change after radiofrequency ablation. Patient I and III functional class of the chronic heart failure are having increasement of QTc duration in acute period of radiofrequency ablation that could be used as an independent predictor of arrhythmia recurrence. Patients with I functional class of the chronic heart failure have significantly lower left atrium size compared to III functional class of the chronic heart failure, which is associated with the best outcome of effectiveness of radiofrequency ablation in the late period.

scholarly journals Catheter ablation of atrial fibrillation in patients with heart failure: impact of maintaining sinus rhythm on heart failure status and long-term rates of stroke and death

EP Europace ◽  
2016 ◽  
Vol 18 (5) ◽  
pp. 679-686 ◽  
Author(s):  
Waqas Ullah ◽  
Liang-Han Ling ◽  
Sandeep Prabhu ◽  
Geoffrey Lee ◽  
Peter Kistler ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Sinus Rhythm ◽  
Patients With Heart Failure

scholarly journals Short- and mid-term results of thoracoscopic atrial fibrillation ablation

2020 ◽  
Vol 8 (4S) ◽  
pp. 82-88
Author(s):  
E. A. Khomenko ◽  
S. E. Mamchur ◽  
K. A. Kozyrin ◽  
R. S. Tarasov ◽  
K. V. Bakovsky
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Catheter Ablation ◽  
Sinus Rhythm ◽  
Left Atrium ◽  
Atrial Flutter ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Pulmonary Veins ◽  
One Year

Aim. Evaluation of short- and mid-term (up to one year) results of aт atrial fibrillation thoracoscopic radiofrequency ablation (TRFA) combined with left atrial appendage resection.Methods. 10 patients with persistent AF were included in the study. In 5 cases surgical ablation was performed as the primary intervention and in 5 cases surgery were preceded by two unsuccessful catheter procedures. Age of the patients was 54.4 (41; 63) years, duration of arrhythmic anamnesis – 5.6 (4.8; 6.8) years, anteroposterior size of the left atrium – 4.7 (45; 51 mm), LV ejection fraction – 63 (58; 68) %. TRFA included an isolation of right and left pulmonary veins, ablation lines along the roof and base of posterior wall of the left atrium, left atrial appendage resection.Results. In all cases of TRFA exit-block from the pulmonary veins was achieved. Among 10 procedures, a stable sinus rhythm was documented in 6 patients. In the remaining 4 patients AF was observed only in one case, and the other three demonstrated atypical atrial flutter, that given us a reason to repeat catheter procedures. In three cases of left atrial flutter, catheter ablation led to sinus rhythm restoration, and in case of AF and total sclerosis of left atrium a decision to refuse RF ablation was made. Complications were presented by a single case of bilateral phrenic nerve palsy, which required plication of the diaphragm, and two spontaneously resolved pulmonary atelectasis.Conclusion. The efficacy of atrial fibrillation thoracoscopic radiofrequency ablation during the follow-up period of one year was 90% regarding selective hybrid approach (thoracoscopic + catheter procedure). Procedure safety of TRFA was much lower than that of catheter ablation: the total number of small and big complications was 30%.

scholarly journals The effectiveness of radiofrequency ablation and repeated cardioversion in combination with antiarrhythmic drug therapy in maintaining stable sinus rhythm in patients with atrial fibrillation and heart failure

Kardiologiia ◽  
2020 ◽  
Vol 60 (8) ◽  
pp. 90-97
Author(s):  
S. I. Seliutskii ◽  
N. M. Savina ◽  
A. V. Chapurnykh
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Sinus Rhythm ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Sf 36 ◽  
Electrocardiogram Monitoring ◽  
Stable Sinus Rhythm

Aim To compare the efficacy of radiofrequency ablation (RFA) and antiarrhythmic therapy (AAT) in patients with atrial fibrillation (AF) and chronic heart failure (CHF) during 12-month observation.Materials and methods This prospective, nonrandomized comparative observational study included 130 patients with AF (men, 65 %; mean age, 62.8±11.8 years) and CHF with left ventricular ejection fraction (LV EF) <50 %. Paroxysmal AF was observed in 60 (46 %) patients and persistent AF was observed in 70 (54 %) patients. According to results of transthoracic echocardiography (EchoCG) 107 (82 %) patients had intermediate LV EF (40–49 %) and 23 (18 %) patients had reduced LV EF (<40 %). RFA of AF was performed for 65 patients whereas 65 patients received an optimal AAT. The 24-h electrocardiogram monitoring, EchoCG, and assessment of the quality of life (QoL) with the SF-36 questionnaire were performed for all patients on admission and at 12 months of observation. Stability of sinus rhythm, EchoCG, QoL, and exercise tolerance were evaluated at 12 months of observation.Results 49 (75%) of patients in the RFA group and 26 (40%) of patients in the AAT group had stable sinus rhythm (SR) at 12 months. Repeated RFA for relapse of AF was performed for 6 (12 %) of 49 patients; repeated cardioversion was performed for 16 (61.5 %) of 26 patients. In the AAT group, there were more interventions for maintaining SR than in the RFA group (p<0.001). In patients with SR of the RFA group at 12 months of observation, LV EF was increased (р<0.001), left ventricular dimension (р<0.001) and volume (р<0.001) were decreased, and mental (р<0.001) and physical (p<0.001) components of health were improved according to the SF-36 questionnaire. In patients with SR of the AAT group, only improvement of mental (р<0.001) and physical (р<0.001) components of health was observed according to the SF-36 questionnaire.Conclusion RFA provided a considerable decrease in the frequency of AF relapse and improvement of LV EF in patients with CHF. The effectiveness of RFA did not depend on the type of arrhythmia. For 12 months of observation, the number of hospitalizations for decompensated CHF and interventions to maintain SR decreased in the RFA group compared to the AAT group.

scholarly journals Tachicardia-induced cardiomyopathy. Case report

2021 ◽  
Vol 93 (4) ◽  
pp. 465-469
Author(s):  
Maria R. Atabegashvili ◽  
Dmitry Yu. Shchekochikhin ◽  
Grigory A. Gromyko ◽  
Ekaterina S. Pershina ◽  
Alexandra A. Bogdanova ◽  
...  
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Catheter Ablation ◽  
Left Ventricle ◽  
Sinus Rhythm ◽  
Atrial Flutter ◽  
Treatment Strategy ◽  
Rare Case ◽  
Clinical Case ◽  
Tachycardia Induced Cardiomyopathy

The tachycardia-induced cardiomyopathy is a rare case of reversible heart failure and left ventricle disfunction. The diagnostic approach and treatment strategy are described in this article. Also the clinical case of heart failure compensation in the patient with left ventricle dilatation and atrial flutter after the reverse to sinus rhythm is after catheter ablation presented.

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