Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO03 - Poster Session III (ID 48) Poster

D-PO03-135 - Prevalence Of HFpEF And Impact Of Catheter Ablation On HFpEF In People With Comorbid Atrial Fibrillation And HFpEF Using Invasive Hemodynamic Testing (ID 1117)

Abstract

Background: Heart Failure with preserved ejection fraction (HFpEF) is common and the combination of AF and HFpEF is associated with poor prognosis. The prevalence of HFpEF in the AF ablation population and the impact of catheter ablation (CA) on HFpEF is not known
Objective: To determine prevalence of HFpEF in people undergoing CA for AF. To determine the impact of CA for AF using invasive haemodynamics in HFpEF
Methods: All patients awaiting their index CA and EF ≥50% were invited to participate in the study. They underwent exercise right heart catheterization (ExRHC), cardiac MRI, echocardiogram, QOL questionnaires and BNP testing. HFpEF was defined by resting pulmonary capillary wedge pressure (PCWP) ≥ 15mmHg or peak exercise PCWP ≥25 mmHg during ExRHC. Patients meeting these criteria were invited to return for ExRHC 6 months after CA
Results: 61 (46.5%) out of 131 patients particiapted in the study of which 54 were included in the analysis. Age 61 ±12years, 23 (43%) female, BMI 30 ±4 Kg/m2. 34 (63%) met diagnostic criteria for HFpEF. HFpEF patients were older (64.7 ±9.7 vs 53.5 ±12.6 p 0.001) with a female predominance (58.8% vs 15.0% p=0.001) and higher E/e’ (11.0 ±3.4 in HFpEF vs 7.3 ±1.6 non HFpEF p <0.001). Of the 26 (76.5%) who underwent an AF ablation, 16 (61.5%) had follow up ExRHC. Seven patients (43.8%) no longer met criteria for HFpEF with decrease in their peak PCWP from 28.6 ± 4.1mmHg to 22.8 ± 1.6 and a decrease in BNP from 72 ± 31.4 to 30.3 ± 18. Baseline demographics are summarized in Table 1
Conclusion: There is a high prevalence of HFpEF in people referred for AF ablation. Atrial fibrillation appears to be an important driver of HFpEF with normalisation in a significant proportion who undergo CA.
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