Staying The Course And Staying Engaged: The Road To Medication Adherence
HFSA ePoster Library. Meraz R. 09/12/21; 343595; 40
Rebecca Meraz
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Abstract
Discussion Forum (0)
Introduction: The prevalence of cardiomyopathy (CM) attributable to atrial fibrillation (AF) is uncertain among patients undergoing AF ablation without other known cause of CM. Objective: To (1) determine how often patients improved from left ventricular ejection fraction (LVEF) < 50% by at least 10 percentage points with ablation (AF-CM) and (2) compare AF-CM profiles to patients with AF and no history of LVEF < 50% (No AF-CM).
Methods: Patients with early-onset AF (age of onset < 65 without known structural or toxin-associated heart disease) were identified from a prospective AF ablation registry with LVEF measured before and after ablation. CM was defined as pre-ablation LVEF < 50% and AF-CM as CM that improved by at least 10 percentage points post-ablation to ≥ 50%.
Results: Of 302 patients (age 55 ± 10 years at first AF ablation), CM was present pre-ablation in 57 (19%) patients, of whom 51 (89%) met the definition of AF-CM, with mean LVEF improving from 38 ± 10% pre-ablation to 60 ± 6% post-ablation (Figure). Of 245 with normal LVEF pre-ablation, 6 developed CM after ablation. AF-CM patients were more likely than No AF-CM to be male, have persistent or permanent AF, and have shorter duration of known AF pre-ablation (4.9 ± 0.6 vs. 6.7 ± 0.7 years, p < 0.01). Pre-ablation heart rate was adequately controlled in both groups but higher in AF-CM (83 ± 26 vs. 70 ± 20 beats per minute, p < 0.01). LV end diastolic dimension was higher in AF-CM (5.2 ± 0.7 vs. 4.8 ± 0.6 cm, p < 0.01) but without severe dilation.
Conclusion: Patients with early-onset AF referred for ablation and otherwise unexplained CM are likely to improve to EF ≥ 50% after ablation. AF ablation should be considered to treat heart failure in these patients, regardless of symptom burden.
Methods: Patients with early-onset AF (age of onset < 65 without known structural or toxin-associated heart disease) were identified from a prospective AF ablation registry with LVEF measured before and after ablation. CM was defined as pre-ablation LVEF < 50% and AF-CM as CM that improved by at least 10 percentage points post-ablation to ≥ 50%.
Results: Of 302 patients (age 55 ± 10 years at first AF ablation), CM was present pre-ablation in 57 (19%) patients, of whom 51 (89%) met the definition of AF-CM, with mean LVEF improving from 38 ± 10% pre-ablation to 60 ± 6% post-ablation (Figure). Of 245 with normal LVEF pre-ablation, 6 developed CM after ablation. AF-CM patients were more likely than No AF-CM to be male, have persistent or permanent AF, and have shorter duration of known AF pre-ablation (4.9 ± 0.6 vs. 6.7 ± 0.7 years, p < 0.01). Pre-ablation heart rate was adequately controlled in both groups but higher in AF-CM (83 ± 26 vs. 70 ± 20 beats per minute, p < 0.01). LV end diastolic dimension was higher in AF-CM (5.2 ± 0.7 vs. 4.8 ± 0.6 cm, p < 0.01) but without severe dilation.
Conclusion: Patients with early-onset AF referred for ablation and otherwise unexplained CM are likely to improve to EF ≥ 50% after ablation. AF ablation should be considered to treat heart failure in these patients, regardless of symptom burden.
Introduction: The prevalence of cardiomyopathy (CM) attributable to atrial fibrillation (AF) is uncertain among patients undergoing AF ablation without other known cause of CM. Objective: To (1) determine how often patients improved from left ventricular ejection fraction (LVEF) < 50% by at least 10 percentage points with ablation (AF-CM) and (2) compare AF-CM profiles to patients with AF and no history of LVEF < 50% (No AF-CM).
Methods: Patients with early-onset AF (age of onset < 65 without known structural or toxin-associated heart disease) were identified from a prospective AF ablation registry with LVEF measured before and after ablation. CM was defined as pre-ablation LVEF < 50% and AF-CM as CM that improved by at least 10 percentage points post-ablation to ≥ 50%.
Results: Of 302 patients (age 55 ± 10 years at first AF ablation), CM was present pre-ablation in 57 (19%) patients, of whom 51 (89%) met the definition of AF-CM, with mean LVEF improving from 38 ± 10% pre-ablation to 60 ± 6% post-ablation (Figure). Of 245 with normal LVEF pre-ablation, 6 developed CM after ablation. AF-CM patients were more likely than No AF-CM to be male, have persistent or permanent AF, and have shorter duration of known AF pre-ablation (4.9 ± 0.6 vs. 6.7 ± 0.7 years, p < 0.01). Pre-ablation heart rate was adequately controlled in both groups but higher in AF-CM (83 ± 26 vs. 70 ± 20 beats per minute, p < 0.01). LV end diastolic dimension was higher in AF-CM (5.2 ± 0.7 vs. 4.8 ± 0.6 cm, p < 0.01) but without severe dilation.
Conclusion: Patients with early-onset AF referred for ablation and otherwise unexplained CM are likely to improve to EF ≥ 50% after ablation. AF ablation should be considered to treat heart failure in these patients, regardless of symptom burden.
Methods: Patients with early-onset AF (age of onset < 65 without known structural or toxin-associated heart disease) were identified from a prospective AF ablation registry with LVEF measured before and after ablation. CM was defined as pre-ablation LVEF < 50% and AF-CM as CM that improved by at least 10 percentage points post-ablation to ≥ 50%.
Results: Of 302 patients (age 55 ± 10 years at first AF ablation), CM was present pre-ablation in 57 (19%) patients, of whom 51 (89%) met the definition of AF-CM, with mean LVEF improving from 38 ± 10% pre-ablation to 60 ± 6% post-ablation (Figure). Of 245 with normal LVEF pre-ablation, 6 developed CM after ablation. AF-CM patients were more likely than No AF-CM to be male, have persistent or permanent AF, and have shorter duration of known AF pre-ablation (4.9 ± 0.6 vs. 6.7 ± 0.7 years, p < 0.01). Pre-ablation heart rate was adequately controlled in both groups but higher in AF-CM (83 ± 26 vs. 70 ± 20 beats per minute, p < 0.01). LV end diastolic dimension was higher in AF-CM (5.2 ± 0.7 vs. 4.8 ± 0.6 cm, p < 0.01) but without severe dilation.
Conclusion: Patients with early-onset AF referred for ablation and otherwise unexplained CM are likely to improve to EF ≥ 50% after ablation. AF ablation should be considered to treat heart failure in these patients, regardless of symptom burden.
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