Ablation of atrial arrhythmias in heart failure

Philip Aagaard; Luigi Di Biase; Andrea Natale

doi:10.1016/j.hfc.2014.12.008

Ablation of atrial arrhythmias in heart failure

Heart Fail Clin. 2015 Apr;11(2):305-17. doi: 10.1016/j.hfc.2014.12.008. Epub 2015 Feb 26.

Authors

Philip Aagaard¹, Luigi Di Biase², Andrea Natale³

Affiliations

¹ Albert Einstein College of Medicine, Montefiore Hospital, Bronx, NY, USA.
² Albert Einstein College of Medicine, Montefiore Hospital, Bronx, NY, USA; Texas Cardiac Arrhythmia Institute, St David's Medical Center, 3000 North I-35, Austin, TX 78705, USA; Department of Cardiology, University of Foggia, Foggia, Italy.
³ Texas Cardiac Arrhythmia Institute, St David's Medical Center, 3000 North I-35, Austin, TX 78705, USA; Department of Biomedical Engineering, University of Texas, Austin, TX, USA; Division of Cardiology, Stanford University, Stanford, CA, USA; Case Western Reserve University, Cleveland, OH, USA; EP Services, California Pacific Medical Center, San Francisco, CA, USA; Interventional Electrophysiology, Scripps Clinic, San Diego, CA, USA. Electronic address: dr.natale@gmail.com.

PMID: 25834977
DOI: 10.1016/j.hfc.2014.12.008

Abstract

HF and AF are on the rise and often coexist. Pharmacologic rhythm control has not been shown to improve outcomes compared with pharmacologic rate control. It is possible that the benefits of maintaining SR are offset by the adverse effects of AADs. Catheter ablation of AF offers an opportunity to achieve SR without the downside of AADs. Several studies have shown that AF ablation improves prognostic markers, including ventricular function, exercise tolerance, and perceived quality of life in HF patients. Studies addressing the impact of this treatment strategy on cardiovascular outcomes and cost-effectiveness are ongoing.

Keywords: Antiarrhythmic drugs; Atrial arrhythmia; Atrial fibrillation; Atrial fibrillation ablation; Heart failure; Rate control; Rhythm control.

Publication types

Review

MeSH terms

Anti-Arrhythmia Agents / therapeutic use
Atrial Fibrillation* / etiology
Atrial Fibrillation* / physiopathology
Atrial Fibrillation* / therapy
Catheter Ablation / methods*
Heart Conduction System / drug effects
Heart Conduction System / pathology
Heart Failure* / complications
Heart Failure* / diagnosis
Heart Failure* / physiopathology
Heart Failure* / psychology
Heart Rate
Humans
Quality of Life*
Stroke Volume
Treatment Outcome

Substances

Anti-Arrhythmia Agents