Author + information
- O.A. Nikolaeva
The recent guidelines had low class indications for AF ablation in patients with chronic heart failure (CHF). Nowadays situation has been slightly improved, but some limitations have been existed yet.
19 patients with impaired left ventricular function (LVEF<45%) and CHF symptoms (I-III NYHA class) with persistent and paroxysmal AF and atrial flutter were included. 12 patients were with AF, 9 of them with long-standing persistent AF (LSPAF), and all atrial flutter (AFl) cases were persistent. Mean LVEF was 39.4±5.89%, LA-volume 92±31.9 ml. We performed ablation procedure using the Ensite Velocity navigation system (St.Jude Medical, USA) and Blazer OI catheters (Boston Scientific, US). In all cases intracardiac echo 10F AcuNav catheters (Biosense Webster, USA) have been used.
We restored sinus rhythm during ablation. All patients with AFl restored normal sinus during ablation delivery, and only 1 pts with LSPAF. After 3 months of follow-up we had 3 pts with recurrent AF among LSPAF patients. Mean LVEF was slightly higher 42.6±3.46% (p=0.083). After 1 year of follow-up we got 58% (11) of total efficacy after one procedure. After 2 years we had 68.4% (13) patients with sinus rhythm after 1 or 2 procedures, mean LVEF was 42.73±2.74% (p=0.061).
AF and AFl-ablation leads to improvement of symptoms and left ventricular systolic function in patients with CHF.