The following is a summary of “Predictors of improvement in left ventricular systolic function after catheter ablation in patients with persistent atrial fibrillation complicated with heart failure,” published in the March 2024 issue of Cardiology by Zhao et al.
Enhancement of left ventricular systolic function in patients with persistent atrial fibrillation (PeAF) and heart failure (HF) undergoing catheter ablation (CA) remains an essential yet challenging aspect of clinical management. While CA has demonstrated efficacy in improving these patients’ left ventricular ejection fraction (LVEF), identifying specific predictors of this improvement remains unclear. In this study, conducted between January 2019 and March 2023, researchers aimed to elucidate factors associated with enhanced LVEF in PeAF patients with HF following CA. Among 435 patients with persistent AF, those with left ventricular systolic dysfunction (LVEF < 50%) measured by transthoracic echocardiography (TTE) within one month before CA were included.
Patients were categorized into improved or non-improved groups based on LVEF changes at 6 months post-CA, with the improvement group defined by the ‘2021 Universal Definition of HF’ criteria for LVEF recovery. Of the 80 patients analyzed, 75.0% exhibited LVEF improvement. Univariate analysis revealed left ventricular end-diastolic diameter (LVDd) and low voltage zones (LVZs) in the left atrium as associated factors for LVEF improvement. Receiver operating characteristic analysis identified a suitable LVDd cutoff value of 59 mm for predicting improvement. Multivariate analysis further confirmed LVDd and LVZs as independent predictors of LVEF improvement post-CA. Additionally, left atrial diameter, LVDd, and ventricular rate significantly improved after radiofrequency CA. These findings underscore the potential utility of LVDd < 59 mm and the absence of LVZs in the left atrium as predictive markers for LVEF enhancement following atrial fibrillation ablation, providing valuable insights for risk stratification and personalized treatment approaches in this patient population.
Source: bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-024-03840-z