Arrhythmias & electrophysiology
Catheter Ablation (CA) in Atrial Fibrillation (AF) With Left Ventricular Systolic Dysfunction (LVSD) With and Without LV Fibrosis
- randomized study
Authors' conclusion
In AF with LVSD, CA is associated with substantial improvement in LV systolic function and clinical status regardless of LGE status. Absolute 12-month LVEF and normalization rates are lower in LGE-positive patients, consistent with greater baseline disease severity, whereas higher scar burden appears to modulate the magnitude of recovery and may inform expectations regarding outcomes.
Study context
- Population
- Patients with AF and LVSD who underwent CA, stratified by LV late gadolinium enhancement on cardiac magnetic resonancepatients underwent CA · late gadolinium enhancement (LGE) positive 40 · LGE negative 40
- Participants
- Eighty patients
- Comparison
- outcomes of CA in patients with AF and LVSD stratified by the presence or absence of LV late gadolinium enhancement (LGE)
- LGE positiven = 40
- LGE negativen = 40
Primary result
As reported in the abstract
LGE positive
+20.3
ΔLVEF · ± 11.0 · %
LGE negative
+21.7
ΔLVEF · ± 11.8 · %
P = 0.578
Further findings
Unadjusted 12-month LVEF · lower in LGE-positive patients
P = 0.019
LVEF normalization (LVEF ≥50%) · 12 months · fewer LGE-positive patients achieved normalization
P = 0.004
- Unadjusted 12-month left ventricular ejection fraction (LVEF) — Adjusted 12-month LVEF analysis: after adjustment for baseline cardiac magnetic resonance and markers of baseline disease severity, LGE status was not independently associated with 12-month LVEF, P =
- 0.849
Arrhythmia-free survival and AF burden reduction
- Comparable between groups
Biomarkers, functional status, and quality of life
- Improvements occurred in both groups
LVEF recovery by LGE burden
- Higher LGE burden (>20%) associated with attenuated LVEF recovery
Original publication
Summarised from the published abstract; every number is checked against it