scholarly journals Long‐term outcomes of index cryoballoon ablation or point‐by‐point radiofrequency ablation in patients with atrial fibrillation and systolic heart failure

2021 ◽  
Author(s):  
S. Prabhu ◽  
N. Ahluwalia ◽  
S. M. Tyebally ◽  
A. S. C. Dennis ◽  
S. O. Malomo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Systolic Heart Failure ◽  
Cryoballoon Ablation ◽  
Long Term Outcomes

scholarly journals Long-term Outcomes of Index Cryo-balloon ablation in Patients with Atrial Fibrillation and Systolic Heart Failure

2020 ◽  
Author(s):  
Sandeep Prabhu ◽  
Nikhil Ahluwalia ◽  
Sara Tyebally ◽  
Adam Dennis ◽  
Samuel Malomo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Systolic Heart Failure ◽  
Long Term Outcomes ◽  
Balloon Ablation

Abstract 16580: Safety and Efficacy of Cryoballoon Ablation in Patients With Congestive Heart Failure

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Roger Tseng ◽  
Muhanad Al-Zubaidi ◽  
Alexander Homer ◽  
Kelly DanCanay ◽  
Wilber Su
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Congestive Heart Failure ◽  
Radiofrequency Ablation ◽  
Success Rate ◽  
Pulmonary Vein ◽  
Systolic Heart Failure ◽  
Cryoballoon Ablation ◽  
Atrial Fibrillation Burden ◽  
Procedural Success

Background: Irrigated radiofrequency ablation of atrial fibrillation (AF) is challenging in patient with severe systolic congestive heart failure due to large fluid load. The use of cryoballoon ablation in patients with low ejection fraction (EF) and NYHA class II-IV congestive heart failure has not been well described, and may benefit from the lack of fluid bolus and restoration of sinus rhythm. Method: To evaluate the efficacy and safety of cryoballoon ablation for systolic heart failure patients with atrial fibrillation (AF). Single center retrospective review of 832 patients with AF ablation using Arctic Front Advance Cryoballoon (Medtronic, Minneapolis, MN) was performed, and 188 patients has EF less than 35% (24 paroxysmal, 122 persistent, and 42 long-standing persistent, average EF 28%) was analyzed. Procedural tolerance, complications, and impact on congestive heart failure were reviewed over a 12 months follow up. Results: All 188 patients (Average age 68, LA size 5.8 cm) with systolic CHF and atrial fibrillation underwent successful pulmonary vein (PV) isolation and extra-pulmonary vein lesions sets applied using cryoballoon. Non-irrigated radiofrequency ablation was used in (22%) for cavo-tricuspid isthmus flutter ablation. Acute procedural success rate was 100% with length of hospitalization of 1.1 days. Average procedural time was 2.6 hours, and fluid infusion of 0.3 liters, no significant complications was noted. Atrial fibrillation burden was monitored by implantable pacemaker or defibrillator in 118 of 188 patients (63%), and others were monitoring via wearable looping recorders every 3 months. Significant AF burden (<10% atrial high rate burden) was observed in over 67% of the patients, and improvement CHF symptoms were reported in all of the patients with reduction of atrial fibrillation burden. Conclusions: Cryoballoon of AF in systolic CHF population is well tolerated with high procedural success rate and low complication rate. Significant clinical improvement of CHF class was observed in patient with reduction of atrial fibrillation burden. Ongoing collection of data is needed to quantify long-term benefit.

Long-term Outcomes of Surgical Radiofrequency Ablation for Atrial Fibrillation in 3 Groups of Patients

2008 ◽  
Vol 11 (2) ◽  
pp. E110-E116
Author(s):  
Jiri Maly ◽  
Josef Kautzner ◽  
Renata Krausova ◽  
Slavomir Rokosny ◽  
Ivan Netuka ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Long Term Outcomes

Abstract 12368: Impact of Weight Trends on Long-term Outcomes After Atrial Fibrillation Ablation in Obese Patients

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
T J Bunch ◽  
Heidi T May ◽  
Tami L Bair ◽  
Victoria Jacobs ◽  
Brian G Crandall ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Weight Loss ◽  
Catheter Ablation ◽  
Obese Patients ◽  
Long Term Outcomes ◽  
Sustained Weight Loss ◽  
Index Weight ◽  
Af Recurrence

Introduction: Catheter ablation of atrial fibrillation (AF) is an established therapeutic rhythm approach in symptomatic patients. Obesity is a dominant driver of AF recurrence after ablation. Weight reduction strategies lower general AF burden and as such may be critical to long-term success rates after ablation. Hypothesis: Long-term outcomes after AF ablation will be better in obese patients with sustained weight loss. Methods: All patients that underwent an index ablation with a BMI recorded and >30 kg/m 2 and at least 3 years of follow-up were included (n=407). The group was separated and compared by weight trends over the 3 years (1. Lost >3% of index weight, n=141; 2. Maintained index weight ±3%, n=147; 3. Gained >3% of index weight at 3 years, n=119). Long-term outcomes included AF recurrence and a composite defined as major adverse clinical events, MACE (stroke/TIA, heart failure (HF) hospitalization, and death). Results: The average age was 63.6±10.4 years, 59.3% were male and 51.7% had paroxysmal AF. AF comorbidities include: hypertension (79.5%), heart failure (36.0%), sleep apnea (35.2%), diabetes (28.9%), and stroke/TIA (5.9%). Those that maintained their weight (HR: 1.45, p=0.05) and those that gained weight (HR 1.54, p=0.07) were more likely to have AF recurrence compared to those that lost weight. Similarly, MACE increased from 18.4% in those that lost weight at 3 years compared to 18.6% (HR 1.32, p=0.29) in those that maintained their weight and 26.5% in those that gained weight (HR 2.01, p=0.02). A small group of patients (n=5), lost >3% then gained it back and ultimately increased their weight by 3%. This group had the highest rates of AF recurrence (100%). Conclusion: Maintained weight loss is a critical component in reducing AF recurrence rates after index catheter ablation in obese patients. Sustained weight loss also results in a reduction in AF-related comorbidities and mortality.

P6361Prognostic value of discharge heart rate in acute heart failure patients: more relevant in atrial fibrillation?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Vidal-Perez ◽  
R Agra-Bermejo ◽  
D Pascual-Figal ◽  
F Gude Sampedro ◽  
C Abou Jokh ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Rate ◽  
Sinus Rhythm ◽  
Acute Heart Failure ◽  
Left Ventricular Ejection ◽  
Long Term Outcomes ◽  
All Cause Mortality ◽  
One Year

Abstract Background The prognostic impact of heart rate (HR) in acute heart failure (AHF) patients is not well known especially in atrial fibrillation (AF) patients. Purpose The aim of the study was to evaluate the impact of admission HR, discharge HR, HR difference (HRD) (admission- discharge) in AHF patients with sinus rhythm (SR) or AF on long- term outcomes. Methods We included 1398 patients consecutively admitted with AHF between October 2013 and December 2014 from a national multicentric, prospective registry. Logistic regression models were used to estimate the association between admission HR, discharge HR and HR difference and one- year all-cause mortality and HF readmission. Results The mean age of the study population was 72±12 years. Of these, 594 (42.4%) were female, 655 (77.8%) were hypertensive and 655 (46.8%) had diabetes. Among all included patients, 745 (53.2%) had sinus rhythm and 653 (46.7%) had atrial fibrillation. Only discharge HR was associated with one-year all-cause mortality (Relative risk (RR)= 1.182, confidence interval (CI) 95% 1.024–1.366, p=0.022) in SR. In AF patients discharge HR was associated with one-year all-cause mortality (RR= 1.276, CI 95% 1.115–1.459, p≤0.001). We did not observe a prognostic effect of admission HR or HRD on long-term outcomes in both groups. This relationship is not dependent on left ventricular ejection fraction (Figure 1) Effect of post-discharge heart rate Conclusions In AHF patients lower discharge HR, neither the admission nor the difference, is associated with better long-term outcomes especially in AF patients Acknowledgement/Funding Heart Failure Program of the Red de Investigaciόn Cardiovascular del Instituto de Salud Carlos III, Madrid, Spain (RD12/0042) and the Fondo Europeo de

Cardiology consultation in oncology practice: a 5-year survey

2020 ◽  
Vol 50 (12) ◽  
pp. 1419-1425
Author(s):  
Kazuko Tajiri ◽  
Ikuo Sekine ◽  
Hiroyuki Naito ◽  
Momoko Murata ◽  
Siqi Li ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Venous Thromboembolism ◽  
Cancer Treatment ◽  
Multidisciplinary Approach ◽  
Long Term Outcomes ◽  
Oncology Practice ◽  
The University

Abstract Objective Onco-cardiology services are expanding rapidly in Japan. To provide a better service, it is important to consider the needs of oncologists. However, little is known regarding specific needs for which oncologists should consult cardiologists to manage cardiovascular problems of their patients. We analysed cardiology consultations sought by oncologists to evaluate the role of cardiologists in cancer treatment. Method We retrospectively investigated consecutive 2064 cardiology consultations of cancer patients in the University of Tsukuba Hospital, Tsukuba, Japan, between January 2014 and December 2018. Results The most common timing of cardiology consultation was before the commencement of cancer treatment (n = 1355; 65.7%), followed by after the commencement of cancer treatment (n = 686; 33.2%). Among the 361 consultations before the administration of anticancer drugs, 235 (65.1%) were for anthracycline-based regimens. There were 506 (24.5%) consultations for the management of cardiovascular emergencies developing after the commencement of cancer treatment; venous thromboembolism was the most frequent (n = 125; 24.7%), followed by atrial fibrillation (n = 110; 21.7%) and heart failure (n = 74; 14.6%). There were marked differences in the types of cardiovascular emergencies depending on the type of cancer. Conclusions This survey revealed the various cardiovascular problems for which oncologists sought interventions by cardiologists. A multidisciplinary approach in an onco-cardiology service is essential to achieve optimal long-term outcomes.

scholarly journals Effects of Atrial Fibrillation on Long-Term Outcomes in Patients Hospitalized for Heart Failure in Japan

2009 ◽  
Vol 73 (11) ◽  
pp. 2084-2090 ◽  
Author(s):  
Sanae Hamaguchi ◽  
Hisashi Yokoshiki ◽  
Shintaro Kinugawa ◽  
Miyuki Tsuchihashi-Makaya ◽  
Takashi Yokota ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Long Term Outcomes

scholarly journals Pulmonary Vein Capture is a Predictor for Long-Term Success of Stand-Alone Pulmonary Vein Isolation with Cryoballoon Ablation in Patients with Persistent Atrial Fibrillation

2020 ◽  
Author(s):  
Alexey Babak ◽  
Christine Bienvenue Kauffman ◽  
Cynthia Lynady ◽  
Reginald McClellan ◽  
Kalpathi Venkatachalam ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Persistent Atrial Fibrillation ◽  
Cryoballoon Ablation ◽  
Long Term Outcomes ◽  
Initial Strategy ◽  
Study Completion ◽  
Antiarrhythmic Medications ◽  
Better Than

Background: It is unknown whether cryoballoon technology for persistent atrial fibrillation (AF) is a reasonable initial strategy for patients with persistent AF (perAF). Methods: 390 consecutive procedures using cryoballoon for initial AF ablation were evaluated and divided first by clinical presentation: paroxysmal AF (PAF) or perAF, and then whether PV potentials associated PV pacing (PV capture) were identified after ablation. Patients were followed for recurrent AF (median 20 months). Results: PV capture was identified in patients with PAF and perAF (PAF: 20.3% vs. perAF: 14.6%; p < 0.05). No patient charactieristic differences were identified between those patients with or without PV capture. The presence of PV capture was not associated with different outcomes in patients with PAF. However, in patients with perAF, the presence of PV capture was associated with long-term outcomes similar to patients with PAF and significantly better than patients with perAF without PV capture (p < 0.001). In patients with perAF and PV capture, a strategy of reisolation of the PVs only for recurrent AF resulted in 20/23 (87%) patients in sinus rhythm off antiarrhythmic medications at study completion. In patients with PV capture, specific electrophysiologic properties of PV tissue did not have an impact on AF recurrence. Conclusion: PV capture (and not specific PV electrophysiologic characteristics) was associated with decreased recurrent AF in patients with perAF. PV capture may identify those patients with perAF in whom PV isolation alone is sufficient at initial ablation procedure and also as the primary ablation strategy for recurrent AF.

Cryoballoon ablation of atrial fibrillation in patients with advanced systolic heart failure and cardiac implantable electronic devices

2018 ◽  
pp. 1081-1088 ◽  
Author(s):  
Patrycja Pruszkowska ◽  
Radosław Lenarczyk ◽  
Jakub Gumprecht ◽  
Ewa Jedrzejczyk-Patej ◽  
Michał Mazurek ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Electronic Devices ◽  
Systolic Heart Failure ◽  
Cryoballoon Ablation ◽  
Cardiac Implantable Electronic Devices
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