Circulation Reports
Online ISSN : 2434-0790
Arrhythmia/Electrophysiology
Heart Rate Decrease After Atrial Fibrillation Catheter Ablation Predicts Decompensated Heart Failure After the Procedure
Yasuhiro MatsudaMasaharu MasudaTakashige SakioMitsutoshi AsaiOsamu IidaShin OkamotoTakayuki IshiharaKiyonori NantoTakuya TsujimuraYosuke HataHiroyuki UematsuToshiaki Mano
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2022 Volume 4 Issue 10 Pages 461-468

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Abstract

Background: Decompensated heart failure (DHF) can complicate catheter ablation for atrial fibrillation (AF). We investigated the association between heart rate and DHF in AF patients undergoing catheter ablation.

Methods and Results: In all, 1,004 consecutive patients who underwent initial ablation for AF (mean [±SD] age 68±10 years; 34% female; persistent AF n=513 [51%]) were enrolled in the study. Heart rate was assessed before and after ablation. DHF was defined as heart failure requiring medical therapy within 2 days after the procedure. The incidence of DHF was 2% (22 of 1,004 patients). Patients with DHF had a higher prevalence of a history of symptomatic heart failure (11/22 [50%] vs. 160/982 [16%]; P<0.0001) and a greater degree of heart rate decrease after the procedure (−21±29 vs. 2±21 beats/min; P=0.001) than those without DHF. On multivariate analysis, heart rate decrease was a significant independent predictor of DHF (hazard ratio 0.8; 95% confidence interval 0.7–0.9; P=0.004; 10 beats/min-increment).

Conclusions: In patients undergoing AF ablation, a decrease in heart rate after the procedure was an independent predictor of DHF.

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© 2022, THE JAPANESE CIRCULATION SOCIETY

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