دورية أكاديمية
أعرض في EDS

Ablation for atrial fibrillation improves the outcomes in patients with heart failure with preserved ejection fraction.

التفاصيل البيبلوغرافية
العنوان: Ablation for atrial fibrillation improves the outcomes in patients with heart failure with preserved ejection fraction.
المؤلفون: Xie Z; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Fenglin Road 180, Xuhui District, 200032 Shanghai, China., Qi B; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Fenglin Road 180, Xuhui District, 200032 Shanghai, China., Wang Z; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Fenglin Road 180, Xuhui District, 200032 Shanghai, China., Li F; Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China., Chen C; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Fenglin Road 180, Xuhui District, 200032 Shanghai, China., Li C; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Fenglin Road 180, Xuhui District, 200032 Shanghai, China., Yuan S; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Fenglin Road 180, Xuhui District, 200032 Shanghai, China., Yao S; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Fenglin Road 180, Xuhui District, 200032 Shanghai, China., Zhou J; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Fenglin Road 180, Xuhui District, 200032 Shanghai, China., Ge J; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Fenglin Road 180, Xuhui District, 200032 Shanghai, China.; Institutes of Biomedical Sciences, Fudan University, Yixueyuan Road 138, Xuhui District, 200032 Shanghai, China.
المصدر: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2023 Dec 28; Vol. 26 (1).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Oxford University Press Country of Publication: England NLM ID: 100883649 Publication Model: Print Cited Medium: Internet ISSN: 1532-2092 (Electronic) Linking ISSN: 10995129 NLM ISO Abbreviation: Europace Subsets: MEDLINE
أسماء مطبوعة: Publication: 2006- : Oxford : Oxford University Press
Original Publication: London ; Philadelphia : Saunders, c1999-
مواضيع طبية MeSH: Atrial Fibrillation*/diagnosis , Atrial Fibrillation*/surgery , Atrial Fibrillation*/complications , Heart Failure*/diagnosis , Heart Failure*/surgery , Heart Failure*/complications, Humans ; Female ; Aged ; Cohort Studies ; Stroke Volume/physiology ; Risk Factors
مستخلص: Aims: Patients with heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) have worse clinical outcomes than those with sinus rhythm (SR). We aim to investigate whether maintaining SR in patients with HFpEF through a strategy such as AF ablation would improve outcomes.
Methods and Results: This is a cohort study that analysed 1034 patients (median age 69 [63-76] years, 46.2% [478/1034] female) with HFpEF and AF. Of these, 392 patients who underwent first-time AF ablation were assigned to the ablation group, and the remaining 642 patients, who received only medical therapy, were assigned to the no ablation group. The primary endpoint was a composite of all-cause death or rehospitalization for worsening heart failure. After a median follow-up of 39 months, the cumulative incidence of the primary endpoint was significantly lower in the ablation group compared to the no ablation group (adjusted hazard ratio [HR], 0.55 [95% CI, 0.37-0.82], P = 0.003) in the propensity score-matched model. Secondary endpoint analysis showed that the benefit of AF ablation was mainly driven by a reduction in rehospitalization for worsening heart failure (adjusted HR, 0.52 [95% CI, 0.34-0.80], P = 0.003). Patients in the ablation group showed a 33% relative decrease in atrial tachycardia/AF recurrence compared to the no ablation group (adjusted HR, 0.67 [95% CI, 0.54-0.84], P < 0.001).
Conclusion: Among patients with HFpEF and AF, the strategy of AF ablation to maintain SR was associated with a lower risk of the composite outcome of all-cause death or rehospitalization for worsening heart failure.
Competing Interests: Conflict of interest: none declared.
(© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)
التعليقات: Comment in: Europace. 2023 Dec 28;26(1):. (PMID: 38157268)
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معلومات مُعتمدة: 2018YFE0103000 National Key Research and Development Program of China
فهرسة مساهمة: Keywords: Ablation; Atrial fibrillation; Death; Heart failure with preserved ejection fraction; Rehospitalization
تواريخ الأحداث: Date Created: 20231215 Date Completed: 20231229 Latest Revision: 20240115
رمز التحديث: 20240116
مُعرف محوري في PubMed: PMC10754157
DOI: 10.1093/europace/euad363
PMID: 38099508
قاعدة البيانات: MEDLINE
الوصف
تدمد:1532-2092
DOI:10.1093/europace/euad363