*Corresponding author:
Masaharu Masuda
Kansai Rosai Hospital Cardiovascular Center
3-1-69 Inabaso, Amagasaki-shi, Hyogo, 660-8511, Japan
Tel: +81-6-6416-1221
Fax: +81-6-6419-1870
E-mail: masuda-masaharu@kansaih.johas.go.jp
Abstract (244 words)
Introduction: Although decompensated heart failure (DHF) can
complicate catheter ablation of atrial fibrillation (AF), its incidence
and risk factors have not been defined. We sought to investigate the
incidence and risk factors for DHF in these patients.
Methods: In total, 1004 consecutive patients who underwent
initial ablation for AF (age, 68 ± 10 years old; females, 346
[34%]; and persistent AF, 513 [51%]) were enrolled. Δheart
rate, which was defined as heart rate after ablation minus heart rate
before ablation, were calculated. DHF was defined as heart failure
requiring medical therapy during post-procedure hospitalization, or
re-hospitalization due to heart failure < 90 days after the
procedure. DHF was classified into early peri-procedual DHF, which
occurring within 2 days after the procedure, and late peri-procedual
DHF, which occurring ≥ 3 days after the procedure.
Results: The incidence of DHF was 32/1004 (3%) patients.
Patients with DHF had a higher prevalence of a past history of
symptomatic heart failure (17/32 [53%] versus 154/972 [16%],P < 0.01) and lower Δheart rate after the procedure
than those without (−16 ± 28 versus 2 ± 21 beats/min, P< 0.01). On multivariate analysis, lower Δheart rate was a
significant independent predictor of early peri-procedual DHF, while
early recurrence of AF was a significant independent predictor of late
peri-procedual DHF.
Conclusion: In patients with AF, lower Δheart rate was an
independent predictor of early peri-procedual DHF, and early recurrence
of AF was an independent predictor of late peri-procedual DHF.