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

D-PO03-142 - Predictors Of Left Ventricular Function Recovery In Patients With Atrial Fibrillation And Severe Left Ventricular Dysfunction (ID 339)

 M. Cho: Nothing relevant to disclose.


Background: Atrial fibrillation (AF) is clinically important reversible cause of severe left ventricular (LV) dysfunction.
Objective: We tried to find out the predictors of LV reversibility
Methods: Clinical data of 637 patients whom diagnosed with severe LV dysfunction in transthoracic echocardiography (TTE) were evaluated (mean 63.9 years, 72.8% male). The data of patient characteristics, baseline and follow-up TTE (mean 2.9±2.3 years apart) were analyzed. The main outcome is LV recovery which defined as at least 1 grade (or 10% in absolute value) improvement of LV ejection fraction (EF).
Results: Baseline LVEF was 27.1 ± 6.0% which increased to 42.7 ± 14.0% (LV recovery in 63.4%) in the follow-up TTE. The independent predictors of LV non-recovery were LV enlargement (Odd Ratio [OR] 0.57 [95% CI 0.40-0.82]), LA enlargement (OR 0.63 [0.41-0.95]), chronic kidney disease (OR 0.67 [0.40-0.99]), and higher CHA2DS2-VASc score (OR 0.87 [0.76-0.98]). Whereas, presence of RV dysfunction (OR 1.74 [1.23-2.47]), beta-blocker therapy (OR 1.99 [1.41-2.81]), and catheter ablation (CA; OR 2.18 [1.06-4.84]) were predictors of LV recovery. CA associated with higher rate of LV recovery and sinus rhythm (SR) conversion than antiarrhythmics or rate control (77.1% vs. 59.0% vs. 64.4% for LV recovery, p=0.053; 77.1% vs. 58.6% vs. 16.9% for SR conversion p<0.001). In patients underwent CA, LVEF was increased with medical treatment before CA, but even more increased after CA (29.5±4.9% vs. 35.3±9.5% vs. 47.1±13.5% for initial, pre-CA, post-CA, respectively, P<0.001).
Conclusion: Catheter ablation and beta-blocker therapy were useful means of LV recovery.