Document Detail

Pulmonary vein isolation for the treatment of atrial fibrillation in patients with impaired systolic function.
MedLine Citation:
PMID:  15028358     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We aimed to determine the safety and efficacy of pulmonary vein isolation (PVI) in atrial fibrillation (AF) patients with impaired left ventricular (LV) systolic function. BACKGROUND: To date, PVI has been performed primarily in patients with normal LV function. Yet, many AF patients have impaired LV systolic function. The outcomes of PVI in patients with impaired LV systolic function are unknown. METHODS: We included 377 consecutive patients undergoing PVI between December 2000 and January 2003. Ninety-four patients had impaired LV function (ejection fraction [EF] <40%), and they comprised the study group. The control group was the remaining 283 patients who had a normal EF. End points included AF recurrence and changes in EF and quality of life (QoL). RESULTS: Mean EF was 36% in our study group, compared with 54% in controls. After initial PVI, 73% of patients with impaired EF and 87% of patients with normal EF were free of AF recurrence at 14 +/- 6 months (p = 0.03). In the study group, there was a nonsignificant increase in EF of 4.6% and significant improvement in QoL. Complication rates were low and included a 1% risk of pulmonary vein stenosis. CONCLUSIONS: Although the AF recurrence rate after initial PVI in impaired EF patients was higher than in normal EF subjects, nearly three-fourths of patients with impaired EF remained AF-free. Although our sample size was nonrandomized, our results suggest PVI may be a feasible therapeutic option in AF patients with impaired EF. Randomized studies with more patients and longer follow-up are warranted.
Michael S Chen; Nassir F Marrouche; Yaariv Khaykin; A Marc Gillinov; Oussama Wazni; David O Martin; Antonio Rossillo; Atul Verma; Jennifer Cummings; Demet Erciyes; Eduardo Saad; Mandeep Bhargava; Dianna Bash; Robert Schweikert; David Burkhardt; Michelle Williams-Andrews; Alejandro Perez-Lugones; Ahmad Abdul-Karim; Walid Saliba; Andrea Natale
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  43     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-18     Completed Date:  2004-04-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1004-9     Citation Subset:  AIM; IM    
Center for Atrial Fibrillation, Department of Cardiovascular Medicine, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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MeSH Terms
Atrial Fibrillation / complications,  physiopathology,  surgery*
Cardiac Surgical Procedures / methods
Catheter Ablation / methods*
Electrocardiography, Ambulatory
Middle Aged
Postoperative Complications
Pulmonary Veins / pathology,  surgery*
Quality of Life
Retrospective Studies
Treatment Outcome
Ventricular Dysfunction, Left / complications*,  physiopathology,  ultrasonography
Comment In:
J Am Coll Cardiol. 2004 Mar 17;43(6):1010-2   [PMID:  15028359 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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