30 research outputs found
Poor Health-Related Quality of Life of Patients with Indication for Chronic Cardiac Pacemaker Therapy
Troponin I levels in permanent atrial fibrillation—impact of rate control and exercise testing
Effect of Uncertainty on Depression in Patients With Newly Diagnosed Atrial Fibrillation
Quantification of Atrial Tachyarrhythmia Burden with an Implantable Pacemaker Before and After Pulmonary Vein Isolation
Randomized Study of Propofol Effect On Electrophysiological Properties of the Atrioventricular Node in Patients with Nodal Reentrant Tachycardia
Is DDD Pacing Superior to VVI,R? A Study on Cardiac Sympathetic Nerve Activity and Myocardial Oxygen Consumption at Rest and During Exercise
Catheter ablation for atrial fibrillation in congestive heart failure
© 2004 Massachusetts Medical Society.Background - Congestive heart failure and atrial fibrillation often coexist, and each adversely affects the other with respect to management and prognosis. We prospectively evaluated the effect of catheter ablation for atrial fibrillation on left ventricular function in patients with heart failure. Methods - We studied 58 consecutive patients with congestive heart failure and a left ventricular ejection fraction of less than 45 percent who were undergoing catheter ablation for atrial fibrillation. We selected as controls 58 patients without congestive heart failure who were undergoing ablation for atrial fibrillation, matched according to age, sex, and classification of atrial fibrillation. We evaluated the patients' left ventricular function and dimensions, symptom score, exercise capacity, and quality of life at baseline and at months 1, 3, 6, and 12. Results - After a mean (±SD) of 12±7 months, 78 percent of the patients with congestive heart failure and 84 percent of the controls remained in sinus rhythm (P=0.34) (69 percent and 71 percent, respectively, were in sinus rhythm without the administration of antiarrhythmic drugs). The patients with congestive heart failure had significant improvement in left ventricular function (increases in the ejection fraction and fractional shortening of 21±13 percent and 11±7 percent, respectively; P<0.001 for both comparisons), left ventricular dimensions (decreases in the diastolic and systolic diameters of 6±6 mm and 8±7 mm, respectively; P=0.03 and P<0.001, respectively), exercise capacity, symptoms, and quality of life. The ejection fraction improved significantly not only in patients without concurrent structural heart disease (24±10 percent, P<0.001) and those with inadequate rate control before ablation (23±10 percent, P<0.001), but also in those with coexisting heart disease (16±14 percent, P<0.001) and adequate rate control before ablation (17±15 percent, P<0.001). Conclusions - Restoration and maintenance of sinus rhythm by catheter ablation without the use of drugs in patients with congestive heart failure and atrial fibrillation significantly improve cardiac function, symptoms, exercise capacity, and quality of life.Li-Fern Hsu, Pierre Jaïs, Prashanthan Sanders, Stéphane Garrigue, Mélèze Hocini, Fréderic Sacher, Yoshihide Takahashi, Martin Rotter, Jean-Luc Pasquié, Christophe Scavée, Pierre Bordachar, Jacques Clémenty, and Michel Haïssaguerr