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Ablation of Atrial Fibrillation in Chronic Heart Failure Patients: Facts or Fancy?

  • F. Gaita
  • S. Grossi
  • R. Riccardi
  • C. Giustetto
  • E. Caruzzo
  • F. Bianchi
  • L. Vivalda
  • E. Richiardi
  • G. Pistis
Conference paper

Abstract

Heart failure (HF) represents the natural evolution of many cardiovascular diseases. The prevalence of HF varies between 1% and 3% in the general population, being even more frequent in the elderly [1]. Atrial fibrillation (AF) on the other hand, is the most frequent arrhythmia, with a prevalence of 0.5%-1% in the general population and up to 10% in octogenarians [2]. These two diseases often have common causes and they are frequently associated. HF predisposes to AF, which is present in from 10% of patients in NYHA class II and up to 40%-50% of patients in NYHA class IV, with an average of 15%-30% in the whole group of patients with HF [3-6]. AF worsens the outcome of patients with HF. A rapid and irregular ventricular response and the lack of the atrial kick during AF may further reduce cardiac output [7].

Keywords

Atrial Fibrillation Pulmonary Vein Pulmonary Vein Isolation NYHA Class Chronic Heart Failure Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Cleland JG, Clark A (1999) Has the survival of the heart failure population changed? Lessons from trials. Am J Cardiol 83:112D–119DPubMedCrossRefGoogle Scholar
  2. 2.
    Kannel WB, Abbott RD, Savage DD, McNamara PM (1982) Epidemiologic features of chronic atrial fibrillation: the Framingham study. N Engl J Med 306:1018–1022PubMedCrossRefGoogle Scholar
  3. 3.
    Carson PE, Johnson GR, Dunkman WB et al, for the V-HeFT VA Cooperative Studies Group (1993) The influence of atrial fibrillation on prognosis in mild to moderate heart failure. The V-HeFT studies. Circulation 87:VI102–VI110Google Scholar
  4. 4.
    Deedwania PC, Singh BN, Ellenbogen KA et al (1998) Spontaneous conversion and maintenance of sinus rhythm by amiodarone in patients with heart failure and atrial fibrillation. Observation from the Veterans Affairs Congestive Heart Failure Trial on Antiarrhythmic Therapy (CHF-STAT). Circulation 98:2574–2579PubMedCrossRefGoogle Scholar
  5. 5.
    Middlekauff HR, Stevenson WG, Stevenson LW (1991) Prognostic significance of atrial fibrillation in advanced heart failure. A study of 390 patients. Circulation 84:40–48PubMedCrossRefGoogle Scholar
  6. 6.
    The CONSENSUS Trial Study Group (1987) Effect of enalapril on mortality in severe congestive heart failure. Results of Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Eng J Med 316:1429–1435CrossRefGoogle Scholar
  7. 7.
    Pozzoli M, Cioffi G, Traversi E et al (1998) Predictors of primary atrial fibrillation and concomitant clinical and hemodynamic changes in patients with chronic heart failure: a prospective study in 344 patients with baseline sinus rhythm. J Am Coll Cardiol 32:197–204PubMedCrossRefGoogle Scholar
  8. 8.
    Wood MA, Brown-Mahoney C, Kay GN et al (2000) Clinical outcome after ablation and pacing therapy for atrial fibrillation. A meta analysis. Circulation 101:1138–1144PubMedCrossRefGoogle Scholar
  9. 9.
    Ozcan C, Jahangir A, Friedman A et al (2000) Sudden death after RF ablation of the atrioventricular node in patients with atrial fibrillation. J Am Coll cardiol 40:105–110CrossRefGoogle Scholar
  10. 10.
    Haissaguerre M, Jais P, Shah DC et al (2000) Electrophysiological end point for catheter ablation of atrial fibrillation initiated from multiple pulmonary venous foci. Circulation 101:1409–1417PubMedCrossRefGoogle Scholar
  11. 11.
    Pappone C, Rosanio S, Oreto G et al (2000) Circumferential radiofrequency ablation of pulmonary vein ostia. A new anatomic approach for curing atrial fibrillation. Circulation 102:2619–2628PubMedCrossRefGoogle Scholar
  12. 12.
    Ernst S, Schluter M, Ouyang F et al (1999) Modification of the substrate for maintenance of idiopathic human atrial fibrillation: efficacy of radiofrequency ablation using non fluoroscopic catheter guidance. Circulation 100:2085–2092PubMedCrossRefGoogle Scholar
  13. 13.
    Gaita F, Gallotti R, Caló L, Manasse E, Riccardi R, Garberoglio L, Nicolini M, Scaglione M, Di Donna P, Caponi M, Franciosi G (2000) Limited posterior left atrial cryoablation in patients with chronic atrial fibrillation undergoing valvular heart surgery. J Am Coll Cardiol 36:159–166PubMedCrossRefGoogle Scholar
  14. 14.
    Grogan M, Smith HC, Gersh BJ, Wood DL (1992) Left ventricular dysfunction due to atrial fibrillation in patients initially believed to have idiopathic dilated cardiomyopathy. Am J Cardiol 69:1570–1573PubMedCrossRefGoogle Scholar
  15. 15.
    Iga K, Takahashi S, Yamashita M, Hori K et al (1993) Reversible left ventricular dysfunction secondary to rapid atrial fibrillation. Int J Cardiol 41:59–64PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2003

Authors and Affiliations

  • F. Gaita
    • 1
  • S. Grossi
    • 1
  • R. Riccardi
    • 1
  • C. Giustetto
    • 1
  • E. Caruzzo
    • 1
  • F. Bianchi
    • 1
  • L. Vivalda
    • 1
  • E. Richiardi
    • 1
  • G. Pistis
    • 1
  1. 1.Divisione di CardiologiaOspedale Mauriziano Umberto ITurinItaly

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