Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Endowed Professor
Language English
Title The Long-term Result of Left Ventricular Ejection Fraction after Atrial Fibrillation Ablation in Patients with Impaired Left Ventricular Systolic Function
Conference The 83rd Annual Scientific Meeting of the Japanese Circulation Society (JCS2019)
Promoters Japanese Circulation Society
Conference Type Nationwide Conferences
Presentation Type Speech
Lecture Type General
Publisher and common publisher◎YAZAKI Kyoichiro, EJIMA Koichiro, HIGUCHI Satoshi, YAGISHITA Daigo, SHODA Morio, HAGIWARA Nobuhisa
Date 2019/03/29
(city and name of the country)
Yokohama, JAPAN
Summary *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.