所属 医学部 医学科（東京女子医科大学病院） 職種 特任准教授
|発表タイトル||The Long-term Result of Left Ventricular Ejection Fraction after Atrial Fibrillation Ablation in Patients with Impaired Left Ventricular Systolic Function|
|会議名||The 83rd Annual Scientific Meeting of the Japanese Circulation Society (JCS2019)|
|主催者||Japanese Circulation Society|
|発表者・共同発表者||◎YAZAKI Kyoichiro, EJIMA Koichiro, HIGUCHI Satoshi, YAGISHITA Daigo, SHODA Morio, HAGIWARA Nobuhisa|
|概要||*Oral Presentation (English) 9 (A) AF, Ablation, Heart Failure
Background: Catheter ablation of atrial fibrillation (AF) is known to facilitate reverse remodeling of left ventricle (LV). However, the long-term result remains controversial.
Methods: The consecutive 140 patients with impaired LV ejection fraction (EF) less than 50% who underwent AF ablation from August 2009 to May 2016 were included. We measured the LVEF changes 3, 6, 12 months and later after
the final procedure. We defined ¨LVEF improvement¨ as the post-procedural LVEF more than 50% or the change in LVEF more than +20%. We also analyzed clinical factors related to the LVEF improvement.
Results: The averagedb LVEF in all patients increased from 40±8 to 49±10% within a year after AF ablation (p < 0.0001), and was maintained in 49±12% during a mean follow-up of 42 months. The LVEF improvement was achieved in 96 patients (69%) out of 140 (66 patients after 3 months, 7 patients after 6 months, 13 patients after 12 months and 10 patients more than 12 months later). No AF recurrence (p = 0.04), pre-procedural high e´ (p = 0.001), high LVEF (p < 0.0001) and absence of structural heart disease (SHD) (p < 0.0001) were associated with ¨LVEF improvement¨, and the latter three were independent predictors (p = 0.03, p = 0.03 and p = 0.02, respectively).
Conclusions: The LVEF improved mostly in patients with impaired LV systolic function within a year after the final RF ablation although some patients needed more than one year to achieve the LVEF improvement. Preprocedural high e´, high LVEF and the absence of SHD were related to reverse remodeling.