For patients with a-fib and heart failure, mortality rates lower after ablation versus no ablation
FRIDAY, April 17, 2015 (HealthDay News) — Most patients with atrial fibrillation (AF) and systolic heart failure who undergo ablation have AF recurrence at five years, according to a study published in the April issue of the Journal of Cardiovascular Electrophysiology.
T. Jared Bunch, M.D., from the Intermountain Heart Institute in Murray, Utah, and colleagues examined the long-term efficacy and impact of cardiac ablation in patients with severe systolic heart failure. Data were included for three groups of patients with systolic heart failure and five years of follow-up: 267 AF ablation patients receiving their first ablation; 1,068 AF patients who did not receive an ablation; and 1,068 systolic heart failure patients without AF.
The researchers found that 60.7 percent of patients had clinical recurrence of AF at five years. Significant predictors of long-term risk of AF recurrence were diabetes and prior heart attack. In the AF ablation, AF, and no AF groups, long-term mortality rates were 27, 55, and 50 percent, respectively (P < 0.0001); lower rates were attributed to a reduction in cardiovascular mortality. There was no difference in ejection fraction at five years, but heart failure hospitalizations were lower following AF ablation versus AF and no ablation. At five years there was a trend toward lower stroke rates in the AF ablation group.
“Recurrence rates of AF in patients with systolic heart failure after ablation are common at five years, with an anticipated ongoing increase,” the authors write.
Several authors disclosed financial ties to the medical device industry.
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