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Heart failure & cardiomyopathiesCohort study

Clinical outcomes of catheter ablation for atrial fibrillation, atrial flutter, and atrial tachycardia in wild-type transthyretin amyloid cardiomyopathy: a proposed treatment strategy for catheter ablation in each arrhythmia

EuropacePublished

  • Cohort study
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Authors' conclusion

The outcomes of CA for ATTRwt-CM were acceptable, except for multiple focal AT and complex AFL.

Study context

Population
Patients with wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM)54 underwent catheter ablation (CA)
Participants
233 patients
Exposure
CA vs no CA
  • CAn = 54
Outcome
Outcomes of CA for AF/AFL/AT:
  • Recurrence-free rate
  • All-cause mortality
  • CV mortality
  • Heart failure (HF) hospitalization

Main finding

As reported in the abstract

CA

70.1%

Recurrence-free rate of atrial fibrillation (AF)/atrial flutter (AFL)/atrial tachycardia (AT) (multiple CA), 1 year · Recurrence-free rate, 2 years 57.6% · Recurrence-free rate, 5 years 44.0%

CA vs Without CAHazard ratio (95% CI)P value
all-cause mortality
0.342(0.133–0.876)
P = 0.025
CV mortality
0.378(0.146–0.981)
P = 0.045
HF hospitalization
0.488(0.269–0.889)
P = 0.019

Observational data: associations, not effects.

Further findings

Recurrence by arrhythmia type

Paroxysmal AF without AF recurrence
12 of 13
Persistent AF without AF recurrence
27 of 29
Non-CTI-dependent complex AFL recurred
all three
Focal AT or multiple focal ATs beyond atrioventricular (AV) annulus or crista terminalis recurred
10 of 13
No recurrence: Cavotricuspid isthmus (CTI)-dependent AFL, non-CTI-dependent simple AFL terminated by one linear ablation, focal AT from AV annulus or crista terminalis
  • even after multiple CA

Original publication

Clinical outcomes of catheter ablation for atrial fibrillation, atrial flutter, and atrial tachycardia in wild-type transthyretin amyloid cardiomyopathy: a proposed treatment strategy for catheter ablation in each arrhythmia. Europace. Published 27 June 2024. doi:10.1093/europace/euae155
Read the original article ↗PubMedCite RIS · BibTeX

Summarised from the published abstract; every number is checked against it