Bazoukis George, Letsas Konstantinos P, Tse Gary, Naka Katerina K, Korantzopoulos Panagiotis, Ntzani Evangelia, Vlachos Konstantinos, Saplaouras Athanasios, Pagkalidou Eirini, Michalis Lampros K, Sideris Antonios, Efremidis Michael
Department of Cardiology, Electrophysiology Laboratory, Evangelismos General Hospital of Athens, Athens, Greece.
Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, SAR, P.R. China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, SAR, P.R. China.
Clin Cardiol. 2018 Jan;41(1):63-67. doi: 10.1002/clc.22850. Epub 2018 Jan 22.
Atrial fibrillation (AF) ablation is increasingly used in patients with reduced left ventricular ejection fraction (LVEF). The aim of the present study was to evaluate the long-term results of a single radiofrequency catheter ablation procedure in heart failure (HF) patients with AF.
We tested the hypothesis that left atrial ablation is an effective therapeutic modality in patients with heart failure.
Our study included HF patients with LVEF <50% who underwent catheter ablation for AF at our department between January 2010 and March 2017. All patients underwent our institution's protocol for follow-up post-ablation.
The study enrolled a total of 38 patients (mean age, 54.1 ± 12.2 years; 28 [73.7%] males; mean LVEF, 38.2% ± 6.3%). After a mean follow-up period of 38.2 months (range, 5-92 months), 28 patients (73.7%) were free from arrhythmia recurrence. In multivariate analysis, early arrhythmia recurrence (P = 0.03) and amiodarone antiarrhythmic drug administration (P = 0.003) remained independent predictors of arrhythmia recurrence.
The main findings of this study are that (1) a single radiofrequency catheter ablation procedure is an effective and safe modality for AF in patients with concomitant HF; (2) after a mean 3.3 years of follow-up, 73.7% of HF patients remained in sinus rhythm; and (3) early arrhythmia recurrence was a significant predictor of arrhythmia recurrence after the blanking period.
心房颤动（AF）消融术在左心室射血分数（LVEF）降低的患者中应用越来越广泛。本研究的目的是评估对心力衰竭（HF）合并AF患者进行单次射频导管消融术的长期效果。
我们检验了左心房消融术对心力衰竭患者是一种有效治疗方式的假设。
我们的研究纳入了2010年1月至2017年3月期间在我院接受AF导管消融术的LVEF<50%的HF患者。所有患者均按照我院的方案在消融术后进行随访。
该研究共纳入38例患者（平均年龄54.1±12.2岁；男性28例[73.7%]；平均LVEF为38.2%±6.3%）。平均随访38.2个月（范围5 - 92个月）后，28例患者（73.7%）无心律失常复发。在多变量分析中，早期心律失常复发（P = 0.03）和胺碘酮抗心律失常药物的使用（P = 0.003）仍然是心律失常复发的独立预测因素。
本研究的主要发现为：（1）单次射频导管消融术对合并HF的AF患者是一种有效且安全的治疗方式；（2）平均随访3.3年后，73.7%的HF患者维持窦性心律；（3）早期心律失常复发是空白期后心律失常复发的重要预测因素。
