Clinical outcomes and structural remodelling after ablation of atrial fibrillation in heart failure with mildly reduced or mid-range ejection fraction
Dan-Ying Lee
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorCorresponding Author
Ting-Yung Chang
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
Correspondence to: Ting-Yung Chang and Shih-Ling Chang, Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Section 2, Shipai Road, Beitou District, Taipei 112, Taiwan. Tel: 886-2-2875-7156; +886-2-7735-3832; Fax: 886-2-2873-5656 and +886-2-2872-4082. Email: [email protected]; [email protected]
Search for more papers by this authorCorresponding Author
Shih-Lin Chang
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Correspondence to: Ting-Yung Chang and Shih-Ling Chang, Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Section 2, Shipai Road, Beitou District, Taipei 112, Taiwan. Tel: 886-2-2875-7156; +886-2-7735-3832; Fax: 886-2-2873-5656 and +886-2-2872-4082. Email: [email protected]; [email protected]
Search for more papers by this authorYenn-Jiang Lin
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorLi-Wei Lo
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorYu-Feng Hu
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorFa-Po Chung
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorTa-Chuan Tuan
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorTze-Fan Chao
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorJo-Nan Liao
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorChin-Yu Lin
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorLing Kuo
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorChih-Min Liu
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorShih-Ann Chen
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan
Search for more papers by this authorDan-Ying Lee
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorCorresponding Author
Ting-Yung Chang
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
Correspondence to: Ting-Yung Chang and Shih-Ling Chang, Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Section 2, Shipai Road, Beitou District, Taipei 112, Taiwan. Tel: 886-2-2875-7156; +886-2-7735-3832; Fax: 886-2-2873-5656 and +886-2-2872-4082. Email: [email protected]; [email protected]
Search for more papers by this authorCorresponding Author
Shih-Lin Chang
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Correspondence to: Ting-Yung Chang and Shih-Ling Chang, Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Section 2, Shipai Road, Beitou District, Taipei 112, Taiwan. Tel: 886-2-2875-7156; +886-2-7735-3832; Fax: 886-2-2873-5656 and +886-2-2872-4082. Email: [email protected]; [email protected]
Search for more papers by this authorYenn-Jiang Lin
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorLi-Wei Lo
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorYu-Feng Hu
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorFa-Po Chung
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorTa-Chuan Tuan
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorTze-Fan Chao
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorJo-Nan Liao
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorChin-Yu Lin
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorLing Kuo
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorChih-Min Liu
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Search for more papers by this authorShih-Ann Chen
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan
Search for more papers by this authorAbstract
Aims
The efficacy of catheter ablation (CA) on clinical outcomes and cardiac structural remodelling in atrial fibrillation (AF) patients with HF with mildly reduced or mid-range ejection fraction (HFmrEF) remains unclear. We aimed to compare the efficacy of CA with medical therapy (MT) in AF patients with HFmrEF.
Methods and results
We retrospectively screened a total of 36 879 patients with AF between 2005 and 2020. Patients who were initially diagnosed with echocardiography-proved HFmrEF and had follow-up echocardiography were enrolled. After applying propensity score matching in a 1:1 ratio, 72 patients treated by CA (Group 1) and 72 patients receiving MT (Group 2) were taken into further analysis. The co-morbidities were similar between the two groups, except for hyperlipidaemia. After a mean follow-up duration of 58.9 ± 42.6 months, Group 1 had a lower HF hospitalization and all-cause mortality compared with Group 2 (hazard ratio (HR), 0.089 [95% confidence interval (CI), 0.011–0.747]; P = 0.026 and HR, 0.121 [95% CI, 0.016–0.894]; P = 0.038, respectively). As for cardiac structural remodelling, the Group 1 had a better improvement in left ventricular ejection fraction (LVEF) and a more decreased left atrium (LA) diameter than Group 2 (+25.0% ± 18.0% vs. +6.2% ± 21.6%, P = <0.0001 and −1.6 ± 4.7 mm vs. +1.5 ± 8.2 mm, P = 0.008, respectively).
Conclusions
In patients with HFmrEF and AF, CA of AF could reduce both HF hospitalization and all-cause mortality as compared with those with MT. A significant improvement in LVEF and decrease in LA diameter were also observed in the CA group. Early rhythm control with CA should be taken into consideration in patients with HFmrEF and AF.
Conflicts of interest
None declared.
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