Abstract 18321: Impact of Single Catheter Ablation of Atrial Fibrillation on Appropriate and Inappropriate Implantable Cardioverter Defibrillator Therapies in Patients with Cardiomyopathy
Background: Atrial fibrillation (AF) is associated with frequent appropriate and inappropriate ICD therapies. Catheter ablation of AF has been shown to reduce AF burden and improve left ventricular function in heart failure patients but the impact on ICD therapies has not been studied. Here, we tested the hypothesis that AF ablation reduces ICD therapies in patients with cardiomyopathies.
Methods: In 73 consecutive patients (mean age 59 ± 10 years, 85 % male) with previously implanted ICD due to ischemic (n=30) or dilated cardiomyopathy (n=43) undergoing AF catheter ablation, the frequency of appropriate and inappropriate ICD therapies before and after AF ablation were compared.
Results: During mean follow-up of 3.3 ± 3 years prior to AF ablation, 4.5 ± 14.7 therapies per patient-year were delivered as opposed to 1.5 ± 10.9 in period of 1.1 ± 0.9 years after ablation. Therefore, catheter ablation of AF reduced the frequency of all ICD therapies by a factor of 3 (p=.002). Both, inappropriate therapies decreased from 2.7 ± 10.9 to 1.4 ± 10.9 per patient-year (p=.02) and appropriate therapies decreased from 1.7 ± 10.9 to 0.1 ± 0.9 per patient-year (p=.028). While heart failure medication and use of antiarrhythmic drugs was comparable during entire follow-up period, left ventricular ejection fraction (LVEF) was significantly improved from 36 ± 11 to 42 ± 13% (p=.004) after AF ablation.
Conclusions: In patients with ischemic or dilated cardiomyopathy, catheter ablation of AF reduces inappropriate and appropriate ICD therapies and improves LVEF.
- © 2012 by American Heart Association, Inc.