Atrial fibrillation ablation in heart failure: Findings from the ESC-EHRA EORP Atrial Fibrillation Ablation long-term (AFA LT) registry
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Atrial fibrillation ablation in heart failure: Findings from the ESC-EHRA EORP Atrial Fibrillation Ablation long-term (AFA LT) registry. / Temporelli, Pier Luigi; Arbelo, Elena; Laroche, Cécile; Blomström-Lundqvist, Carina; Kirchhof, Paulus; Lip, Gregory Y H; Boriani, Giuseppe; Nakou, Eleni; Maggioni, Aldo P; Tavazzi, Luigi; ESC-EHRA EORP Atrial Fibrillation Ablation Long-Term Registry Investigators.
in: INT J CARDIOL, Jahrgang 346, 01.01.2022, S. 19-26.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Atrial fibrillation ablation in heart failure: Findings from the ESC-EHRA EORP Atrial Fibrillation Ablation long-term (AFA LT) registry
AU - Temporelli, Pier Luigi
AU - Arbelo, Elena
AU - Laroche, Cécile
AU - Blomström-Lundqvist, Carina
AU - Kirchhof, Paulus
AU - Lip, Gregory Y H
AU - Boriani, Giuseppe
AU - Nakou, Eleni
AU - Maggioni, Aldo P
AU - Tavazzi, Luigi
AU - ESC-EHRA EORP Atrial Fibrillation Ablation Long-Term Registry Investigators
N1 - Copyright © 2021 Elsevier B.V. All rights reserved.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - BACKGROUND: The current practice of atrial fibrillation ablation (AFA) as a treatment option for atrial fibrillation (AF) in patients with heart failure (HF) across Europe, their clinical profiles and outcomes is still undefined.METHODS: The European Society of Cardiology (ESC) led a prospective observational registry of consecutive patients undergoing AFA, in 27 member countries. The subgroup of patients with HF, followed-up for 1 year, was analyzed and the results are reported.RESULTS: Of the 3582 AF patients in the Registry, 537 (14.9%) had HF. Diabetes, hypertension, hypercholesterolemia, CHA2DS2-VASc score ≥ 2, structural heart disease and persistent AF were more common in HF than non-HF patients (all p < 0.001). However the in-hospital complications were less frequent in HF patients (5.0% vs. 8.2% p = 0.01). Both in-hospital and 1-year outcomes, including 1-year AF recurrence (15.4%) and repeat ablations (9.5%), were similar in both groups. We subdivided HF patients according to their left ventricular ejection fraction (EF) at baseline into reduced (HFrEF, <40%), mid-range (HFmEF, 40-49%), or preserved EF (HFpEF, ≥ 50%). Most patients were HFpEF (n 375, 77%), 72 (15%) were HFmEF and 8% HFrEF. The most frequent underlying conditions in HFpEF were hypertension and ischemic heart disease, while those most common in HFmEF and HFrEF were valvular and dilated cardiomyopathy.CONCLUSION: In routine care in Europe, HF patients represent a minority of patients undergoing AFA, and most belong to the HFpEF phenotype. The limited clinical research on AFA HFpEF patients is reflected by the uncertainty expressed in the current AF Guidelines and Expert statements.
AB - BACKGROUND: The current practice of atrial fibrillation ablation (AFA) as a treatment option for atrial fibrillation (AF) in patients with heart failure (HF) across Europe, their clinical profiles and outcomes is still undefined.METHODS: The European Society of Cardiology (ESC) led a prospective observational registry of consecutive patients undergoing AFA, in 27 member countries. The subgroup of patients with HF, followed-up for 1 year, was analyzed and the results are reported.RESULTS: Of the 3582 AF patients in the Registry, 537 (14.9%) had HF. Diabetes, hypertension, hypercholesterolemia, CHA2DS2-VASc score ≥ 2, structural heart disease and persistent AF were more common in HF than non-HF patients (all p < 0.001). However the in-hospital complications were less frequent in HF patients (5.0% vs. 8.2% p = 0.01). Both in-hospital and 1-year outcomes, including 1-year AF recurrence (15.4%) and repeat ablations (9.5%), were similar in both groups. We subdivided HF patients according to their left ventricular ejection fraction (EF) at baseline into reduced (HFrEF, <40%), mid-range (HFmEF, 40-49%), or preserved EF (HFpEF, ≥ 50%). Most patients were HFpEF (n 375, 77%), 72 (15%) were HFmEF and 8% HFrEF. The most frequent underlying conditions in HFpEF were hypertension and ischemic heart disease, while those most common in HFmEF and HFrEF were valvular and dilated cardiomyopathy.CONCLUSION: In routine care in Europe, HF patients represent a minority of patients undergoing AFA, and most belong to the HFpEF phenotype. The limited clinical research on AFA HFpEF patients is reflected by the uncertainty expressed in the current AF Guidelines and Expert statements.
KW - Atrial Fibrillation/diagnosis
KW - Cardiology
KW - Heart Failure/diagnosis
KW - Humans
KW - Prognosis
KW - Registries
KW - Stroke Volume
KW - Ventricular Function, Left
U2 - 10.1016/j.ijcard.2021.11.010
DO - 10.1016/j.ijcard.2021.11.010
M3 - SCORING: Journal article
C2 - 34774883
VL - 346
SP - 19
EP - 26
JO - INT J CARDIOL
JF - INT J CARDIOL
SN - 0167-5273
ER -
