Comparing outcomes after pulmonary vein isolation in patients with systolic and diastolic heart failure

Ahmad B. Allaw, MD; Jeremy Treger, MD, PhD; Jia Guo, MD; Dipayon Roy, MD; Amulya Gampa, MD; Swati Rao, MD; Stephanie A. Besser, MSAS; Andrew D. Beaser, MD; Zaid Aziz, MD; Cevher Ozcan, MD; Srinath Yeshwant, MD; Gaurav A. Upadhyay, MD

Heart Rhythm O2 (Aug 2024)

Comparing outcomes after pulmonary vein isolation in patients with systolic and diastolic heart failure

Ahmad B. Allaw, MD,
Jeremy Treger, MD, PhD,
Jia Guo, MD,
Dipayon Roy, MD,
Amulya Gampa, MD,
Swati Rao, MD,
Stephanie A. Besser, MSAS,
Andrew D. Beaser, MD,
Zaid Aziz, MD,
Cevher Ozcan, MD,
Srinath Yeshwant, MD,
Gaurav A. Upadhyay, MD

Affiliations

Ahmad B. Allaw, MD: Center for Arrhythmia Care, Heart and Vascular Institute, University of Chicago, Chicago, Illinois
Jeremy Treger, MD, PhD: Center for Arrhythmia Care, Heart and Vascular Institute, University of Chicago, Chicago, Illinois
Jia Guo, MD: Center for Arrhythmia Care, Heart and Vascular Institute, University of Chicago, Chicago, Illinois
Dipayon Roy, MD: Center for Arrhythmia Care, Heart and Vascular Institute, University of Chicago, Chicago, Illinois
Amulya Gampa, MD: Center for Arrhythmia Care, Heart and Vascular Institute, University of Chicago, Chicago, Illinois
Swati Rao, MD: Center for Arrhythmia Care, Heart and Vascular Institute, University of Chicago, Chicago, Illinois
Stephanie A. Besser, MSAS: Center for Arrhythmia Care, Heart and Vascular Institute, University of Chicago, Chicago, Illinois
Andrew D. Beaser, MD: Center for Arrhythmia Care, Heart and Vascular Institute, University of Chicago, Chicago, Illinois
Zaid Aziz, MD: Center for Arrhythmia Care, Heart and Vascular Institute, University of Chicago, Chicago, Illinois
Cevher Ozcan, MD: Center for Arrhythmia Care, Heart and Vascular Institute, University of Chicago, Chicago, Illinois
Srinath Yeshwant, MD: Center for Arrhythmia Care, Heart and Vascular Institute, University of Chicago, Chicago, Illinois
Gaurav A. Upadhyay, MD: Address reprint requests and correspondence: Dr Gaurav A. Upadhyay, Center for Arrhythmia Care, The University of Chicago Pritzker School of Medicine, 5841 S Maryland Avenue, MC 9024, Chicago, IL 60637.; Center for Arrhythmia Care, Heart and Vascular Institute, University of Chicago, Chicago, Illinois

Journal volume & issue: Vol. 5, no. 8
pp. 529 – 537

Abstract

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Background: The benefit of pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) is well established; its efficacy in patients with heart failure preserved ejection fraction (HFpEF) is less clear. Objective: The objective of the study was to compare AF and heart failure (HF) rehospitalizations after PVI in patients with HFpEF vs HFrEF. Methods: The IBM MarketScan Database was used to identify patients undergoing PVI for AF. Patients were categorized by HF status: absence of HF, presence of HFrEF, or presence of HFpEF. Primary outcomes were HF and arrhythmia hospitalizations after PVI. Results: A total of 32,524 patients were analyzed: 27,900 with no HF (86%), 2948 with HFrEF (9%), and 1676 with HFpEF (5%). Compared with those with no HF, both patients with HFrEF and HFpEF were more likely to be hospitalized for HF (hazard ratio [HR] 7.27; P 1 year), patients with HFpEF were more likely to have HF (HR 1.30; P < .01) and arrhythmia (HR 1.19; P < .01) rehospitalizations. Conclusion: Reductions in HF and arrhythmia hospitalizations are observed early after PVI across all patients with HF, but patients with HFpEF demonstrate higher HF rehospitalization and arrhythmia recurrence in longer-term follow-up than do patients with HFrEF.

Published in Heart Rhythm O2

ISSN: 2666-5018 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/heart-rhythm-o2

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