Arrhythmias & electrophysiology
Left ventricular ejection fraction response after atrial fibrillation ablation: Clinical predictors and development of the PACED score
Authors' conclusion
LVEF response post-AF ablation in patients with LVSD can be accurately predicted precatheter ablation with a bedside score. Left ventricular response depends primarily on substrate and conduction characteristics rather than pharmacotherapy in a guideline-directed medical therapy-optimized cohort. Late gadolinium enhancement on cardiac magnetic resonance is associated with an increased chance of being a nonresponder to ablation.
Study context
- Population
- Patients with atrial fibrillation (AF) and left ventricular ejection fraction (LVEF) <50% undergoing index ablation
- Participants
- 366 patients
- Outcome
- Responder status: ≥10% increase in LVEF or improvement to ≥50% on follow-up echocardiography
- Follow-up
- After the final ablation
Main finding
As reported in the abstract
LV responders
70.8%
PACED score <2: probability of response
87%
PACED score ≥3: probability of nonresponse
71%
PACED score c-statistic
0.83
95% CI 0.77–0.89
Observational data: associations, not effects.
Further findings
Late gadolinium enhancement on CMR, nonresponders vs responders (CMR subcohort)
P < 0.001
Guideline-directed medical therapy at baseline
- Not independently associated with recovery
Original publication
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