Your browser doesn't support javascript.
loading
Impact of cavotricuspid isthmus ablation for typical atrial flutter and heart failure in the elderly-results of a retrospective multi-center study.
Boxhammer, Elke; Bellamine, Meriem; Szendey, Istvan; Foresti, Mike; Bonsels, Marc; Kletzer, Joseph; Jirak, Peter; Topf, Albert; Kraus, Johannes; Fiedler, Lukas; Dieplinger, Anna-Maria; Hoppe, Uta C; Strohmer, Bernhard; Eckardt, Lars; Pistulli, Rudin; Motloch, Lukas J; Larbig, Robert.
Afiliação
  • Boxhammer E; Clinic II for Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
  • Bellamine M; Division of Cardiology, Hospital Maria Hilf Mönchengladbach, Mönchengladbach, Germany.
  • Szendey I; Division of Cardiology, Hospital Maria Hilf Mönchengladbach, Mönchengladbach, Germany.
  • Foresti M; Division of Cardiology, Hospital Maria Hilf Mönchengladbach, Mönchengladbach, Germany.
  • Bonsels M; Division of Cardiology, Hospital Maria Hilf Mönchengladbach, Mönchengladbach, Germany.
  • Kletzer J; Clinic II for Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
  • Jirak P; Clinic II for Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
  • Topf A; Clinic II for Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
  • Kraus J; Clinic for Internal Medicine, Hospital Villach, Villach, Austria.
  • Fiedler L; Clinic II for Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
  • Dieplinger AM; Clinic II for Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
  • Hoppe UC; Department of Internal Medicine II, Wiener Neustadt Hospital, Wiener Neustadt, Austria.
  • Strohmer B; Medical Faculty, Johannes Kepler University Linz, Linz, Austria.
  • Eckardt L; Nursing Science Program, Institute for Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria.
  • Pistulli R; Clinic II for Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
  • Motloch LJ; Clinic II for Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
  • Larbig R; Department of Cardiology II-Electrophysiology, University Hospital Muenster, Muenster, Germany.
Front Cardiovasc Med ; 10: 1109404, 2023.
Article em En | MEDLINE | ID: mdl-37139138
Introduction: While in the CASTLE-AF trial, in patients with atrial fibrillation and heart failure with reduced ejection fraction, interventional therapy using pulmonary vein isolation was associated with outcome improvement, data on cavotricuspid isthmus ablation (CTIA) in atrial flutter (AFL) in the elderly is rare. Methods: We included 96 patients between 60 and 85 years with typical AFL and heart failure with reduced or mildly reduced ejection fraction (HFrEF/HFmrEF) treated in two medical centers. 48 patients underwent an electrophysiological study with CTIA, whereas 48 patients received rate or rhythm control and guideline-compliant heart failure therapy. Patients were followed up for 2 years, with emphasis on left ventricular ejection fraction (LVEF) over time. Primary endpoints were cardiovascular mortality and hospitalization for cardiac causes. Results: Patients with CTIA showed a significant increase in LVEF after 1 (p < 0.001) and 2 years (p < 0.001) in contrast to baseline LVEF. Improvement of LVEF in the CTIA group was associated with significantly lower 2-year mortality (p = 0.003). In the multivariate regression analysis, CTIA remained the relevant factor associated with LVEF improvement (HR: 2.845 CI:95% 1.044-7.755; p = 0.041). Elderly patients (≥ 70 years) further benefited from CTIA, since they showed a significantly reduced rehospitalization (p = 0.042) and mortality rate after 2 years (p = 0.013). Conclusions: CTIA in patients with typical AFL and HFrEF/HFmrEF was associated with significant improvement of LVEF and reduced mortality rates after 2 years. Patient age should not be a primary exclusion criterion for CTIA, since patients ≥70 years also seem to benefit from intervention in terms of mortality and hospitalization.
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2023 Tipo de documento: Article