Frontiers in Cardiovascular Medicine (Jan 2024)
Catheter ablation in patients with atrial fibrillation and dilated cardiomyopathy
- Yoon-Kee Siow,
- Yoon-Kee Siow,
- Chin-Yu Lin,
- Chin-Yu Lin,
- Fa-Po Chung,
- Fa-Po Chung,
- Yenn-Jiang Lin,
- Yenn-Jiang Lin,
- Shih-Lin Chang,
- Shih-Lin Chang,
- Li-Wei Lo,
- Li-Wei Lo,
- Yu-Feng Hu,
- Yu-Feng Hu,
- Jo-Nan Liao,
- Jo-Nan Liao,
- Ting-Yung Chang,
- Ting-Yung Chang,
- Ta-Chuan Tuan,
- Ta-Chuan Tuan,
- Ling Kuo,
- Ling Kuo,
- Cheng-I Wu,
- Cheng-I Wu,
- Chih-Min Liu,
- Chih-Min Liu,
- Shin-Huei Liu,
- Shin-Huei Liu,
- Guan-Yi Li,
- Ming-Jen Kuo,
- Ming-Jen Kuo,
- Ming-Jen Kuo,
- Shang-Ju Wu,
- Shang-Ju Wu,
- Jose Antonio Bautista,
- Yu-Shan Huang,
- Dinh Son Ngoc Nguyen,
- Shih-Ann Chen,
- Shih-Ann Chen,
- Shih-Ann Chen,
- Shih-Ann Chen
Affiliations
- Yoon-Kee Siow
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Yoon-Kee Siow
- Division of Cardiology, Serdang Hospital, Selangor, Malaysia
- Chin-Yu Lin
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Chin-Yu Lin
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Fa-Po Chung
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Fa-Po Chung
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Yenn-Jiang Lin
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Yenn-Jiang Lin
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Shih-Lin Chang
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Shih-Lin Chang
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Li-Wei Lo
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Li-Wei Lo
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Yu-Feng Hu
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Yu-Feng Hu
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Jo-Nan Liao
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Jo-Nan Liao
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Ting-Yung Chang
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Ting-Yung Chang
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Ta-Chuan Tuan
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Ta-Chuan Tuan
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Ling Kuo
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Ling Kuo
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Cheng-I Wu
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Cheng-I Wu
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Chih-Min Liu
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Chih-Min Liu
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Shin-Huei Liu
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Shin-Huei Liu
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Guan-Yi Li
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Ming-Jen Kuo
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Ming-Jen Kuo
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Ming-Jen Kuo
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan
- Shang-Ju Wu
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Shang-Ju Wu
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan
- Jose Antonio Bautista
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Yu-Shan Huang
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Dinh Son Ngoc Nguyen
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Shih-Ann Chen
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Shih-Ann Chen
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Shih-Ann Chen
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan
- Shih-Ann Chen
- Department of Medicine, National Chung Hsing University, Taichung, Taiwan
- DOI
- https://doi.org/10.3389/fcvm.2024.1305485
- Journal volume & issue
-
Vol. 11
Abstract
IntroductionCatheter ablation is an effective and safe strategy for treating atrial fibrillation patients. Nevertheless, studies on the long-term outcomes of catheter ablation in patients with dilated cardiomyopathy are limited. This study aimed to assess the electrophysiological characteristics of atrial fibrillation patients with dilated cardiomyopathy and compare the long-term clinical outcomes between patients undergoing catheter ablation and medical therapy.MethodPatient baseline characteristics and electrophysiological parameters were examined to identify the predictors of atrial fibrillation recurrence following catheter ablation. The clinical outcomes of catheter ablation and medical therapy were compared using the propensity score matched method.ResultsA total of 343 patients were enrolled, with 46 in the catheter ablation group and 297 in the medical therapy group. Among the catheter ablation group, 58.7% (n = 27) had persistent atrial fibrillation. The recurrence rate of atrial arrhythmia was 30.4% (n = 14) after an average follow-up duration of 7.7 years following catheter ablation. The only predictive factor for atrial fibrillation recurrence after catheter ablation was the left atrial diameter. When compared to medical therapy, catheter ablation demonstrated significantly better outcomes in terms of overall survival, freedom from heart failure hospitalization, improvement in left ventricular ejection fraction, and a greater reduction in left ventricular diameter and left atrial diameter after propensity score matching.ConclusionsTherefore, catheter ablation proves to be effective in providing long-term control of atrial fibrillation in patients with dilated cardiomyopathy. In addition to standard heart failure care, catheter ablation significantly enhanced both morbidity and mortality outcomes and reversed structural remodeling when compared to heart failure medication alone.
Keywords
