Atrial Fibrillation Ablation in Heart Failure and Preserved Ejection Fraction: An Observational Study of Risk Factors for Heart Failure Hospitalization.

IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Current Cardiology Reviews Pub Date : 2024-12-09 DOI:10.2174/011573403X348844241129111639
Rundi Qi, Hailei Liu, Yue Zhu, Nan Wu, Kexin Wang, Xiangwei Ding, Zhoushan Gu, Mingfang Li, Hongwu Chen, Weizhu Ju, Xin Li, Minglong Chen
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Abstract

Introduction: Long-term heart failure hospitalization (HFH) after radiofrequency catheter ablation (RFCA) in atrial fibrillation (AF) patients with heart failure and preserved ejection fraction (HFpEF) and its risk factors remain to be investigated.

Methods: AF patients with HFpEF who underwent RFCA from January, 2014 to December, 2018 from three centers were retrospectively included. Patients were assigned to the training and testing cohorts, respectively. In the training cohort, logistic regression analyses were performed to discriminate those with and without HFH. A scoring system was developed accordingly and validated.

Results: A total of 417 AF patients with HFpEF receiving RFCA were enrolled. About 35 patients (8.4%) had HFH for 6 years. In the training cohort, the use of diuretics, atrial tachycardia (AT)/AF recurrence, prior HFH, and female sex were independent predictors of HFH in the multivariable analysis. A DAPF score (ranging from 0 to 9.0) was developed. The area under the receiver operating characteristic curve (AUC) of the DAPF score was 0.880 (95% CI, 0.830- 0.929). A DAPF score ≥3.5 could predict HFH with a sensitivity of 81.8% and a specificity of 74.6%. The performance in the testing cohort remained robust (AUC, 0.858; 95% CI, 0.749- 0.967).

Conclusion: HFH in patients with AF and HFpEF after RFCA is not rare. The DAPF score could predict the risk of HFH in AF patients with HFpEF after RFCA and guide our treatment strategy.

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房颤消融治疗心力衰竭和保留射血分数:心力衰竭住院危险因素的观察性研究
导读:心房颤动(AF)合并心力衰竭和保留射血分数(HFpEF)患者射频导管消融(RFCA)后长期心力衰竭住院(HFH)及其危险因素仍有待研究。方法:回顾性分析2014年1月至2018年12月来自三个中心的房颤合并HFpEF患者行RFCA的病例。患者分别被分配到训练组和测试组。在培训队列中,进行逻辑回归分析以区分患有和不患有HFH的人。据此开发并验证了评分系统。结果:共纳入417例接受RFCA治疗的HFpEF AF患者。约35例(8.4%)患者患有6年HFH。在训练队列中,在多变量分析中,利尿剂的使用、心房心动过速(AT)/房颤复发、既往HFH和女性性别是HFH的独立预测因素。制定DAPF评分(0 ~ 9.0)。DAPF评分的受试者工作特征曲线下面积(AUC)为0.880 (95% CI, 0.830 ~ 0.929)。DAPF评分≥3.5可预测HFH,敏感性为81.8%,特异性为74.6%。在测试队列中的表现仍然稳健(AUC, 0.858;95% ci, 0.749- 0.967)。结论:房颤合并HFpEF术后并发HFH并不少见。DAPF评分可以预测AF合并HFpEF患者RFCA后HFH的发生风险,指导我们的治疗策略。
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来源期刊
Current Cardiology Reviews
Current Cardiology Reviews CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.70
自引率
10.50%
发文量
117
期刊介绍: Current Cardiology Reviews publishes frontier reviews of high quality on all the latest advances on the practical and clinical approach to the diagnosis and treatment of cardiovascular disease. All relevant areas are covered by the journal including arrhythmia, congestive heart failure, cardiomyopathy, congenital heart disease, drugs, methodology, pacing, and preventive cardiology. The journal is essential reading for all researchers and clinicians in cardiology.
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