Clinical progress of catheter ablation in patients with atrial fibrillation and heart failure with preserved ejection fraction

doi:10.16138/j.1673-6087.2024.03.07

Abstract

Abstract:

Atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) are 2 common and often coexistent conditions, and have significant impact on cardiovascular morbidity and mortality. HFpEF is characterized as atrial fibrosis and left atrial myopathy, and AF could be the cause or consequence of HFpEF. Recent data suggest that sinus rhythm restoration with catheter ablation may be a useful intervention to improve disease progression in AF-HFpEF, which could reduce HFpEF severity, decrease AF burden, overall rehospitalization rate and mortality. In the review, we will focus on the pathophysiology of AF-HFpEF, the role and clinical progress of catheter ablation in these patients.

Key words: Atrial fibrillation, Heart failure with preserved ejection fraction, Left atrial myopathy, Catheter ablation, Epidemiology

CLC Number:

R541.75

SUN Yiya, LUO Qingzhi, JIN Qi, WU Liqun. Clinical progress of catheter ablation in patients with atrial fibrillation and heart failure with preserved ejection fraction[J]. Journal of Internal Medicine Concepts & Practice, 2024, 19(03): 188-192.

References 38

[1]	Nair N. Epidemiology and pathogenesis of heart failure with preserved ejection fraction[J]. Rev Cardiovasc Med, 2020, 21(4):531-540.
[2]	Santhanakrishnan R, Wang N, Larson MG, et al. Atrial fibrillation begets heart failure and vice versa[J]. Circulation, 2016, 133(5):484-492. doi: 10.1161/CIRCULATIONAHA.115.018614 pmid: 26746177
[3]	Cikes M, Claggett B, Shah AM, et al. Atrial fibrillation in heart failure with preserved ejection fraction[J]. JACC Heart Fail, 2018, 6(8):689-697.
[4]	Liu G, Long M, Hu X, et al. Meta-analysis of atrial fibrillation and outcomes in patients with heart failure and preserved ejection fraction[J]. Heart Lung Circ, 2021, 30(5):698-706. doi: 10.1016/j.hlc.2020.10.010 pmid: 33191141
[5]	Son MK, Park JJ, Lim NK, et al. Impact of atrial fibrillation in patients with heart failure and reduced, mid-range or preserved ejection fraction[J]. Heart, 2020, 106(15):1160-1168. doi: 10.1136/heartjnl-2019-316219 pmid: 32341140
[6]	Ariyaratnam JP, Lau DH, Sanders P, et al. Atrial fibrillation and heart failure: epidemiology, pathophysiology, prognosis, and management[J]. Card Electrophysiol Clin, 2021, 13(1):47-62. doi: 10.1016/j.ccep.2020.11.004 pmid: 33516407
[7]	Uhm JS, Kim J, Yu HT, et al. Stroke and systemic embolism in patients with atrial fibrillation and heart failure according to heart failure type[J]. ESC Heart Fail, 2021, 8(2):1582-1589.
[8]	Zakeri R. Is there a role for catheter ablation of atrial fibrillation in the treatment of patients with heart failure and preserved ejection fraction?[J]. Circ Heart Fail, 2022, 15(9):e009835.
[9]	Reddy YNV, Obokata M, Wiley B, et al. The haemodynamic basis of lung congestion during exercise in heart failure with preserved ejection fraction[J]. Eur Heart J, 2019, 40(45):3721-3730. doi: 10.1093/eurheartj/ehz713 pmid: 31609443
[10]	Reddy YNV, Obokata M, Verbrugge FH, et al. Atrial dysfunction in patients with heart failure with preserved ejection fraction and atrial fibrillation[J]. J Am Coll Cardiol, 2020, 76(9):1051-1064.
[11]	Rivner H, Mitrani RD, Goldberger JJ. Atrial myopathy underlying atrial fibrillation[J]. Arrhythm Electrophysiol Rev, 2020, 9(2):61-70. doi: 10.15420/aer.2020.13 pmid: 32983526
[12]	Ihara K, Sasano T. Role of inflammation in the pathogenesis of atrial fibrillation[J]. Front Physiol, 2022, 13(862164):862164.
[13]	Shaihov-Teper O, Ram E, Ballan N, et al. Extracellular vesicles from epicardial fat facilitate atrial fibrillation[J]. Circulation, 2021, 143(25):2475-2493. doi: 10.1161/CIRCULATIONAHA.120.052009 pmid: 33793321
[14]	Kenchaiah S, Ding J, Carr JJ, et al. Pericardial fat and the risk of heart failure[J]. J Am Coll Cardiol, 2021, 77(21):2638-2652. doi: 10.1016/j.jacc.2021.04.003 pmid: 34045020
[15]	Kirchhof P, Camm AJ, Goette A, et al. Early rhythm-control therapy in patients with atrial fibrillation[J]. N Engl J Med, 2020, 383(14):1305-1316.
[16]	Kelly JP, DeVore AD, Wu J, et al. Rhythm control versus rate control in patients with atrial fibrillation and heart failure with preserved ejection fraction[J]. J Am Heart Assoc, 2019, 8(24):e011560.
[17]	Parkash R, Wells GA, Rouleau J, et al. Randomized ablation-based rhythm-control versus rate-control trial in patients with heart failure and atrial fibrillation[J]. Circulation, 2022, 145(23):1693-1704. doi: 10.1161/CIRCULATIONAHA.121.057095 pmid: 35313733
[18]	中华医学会心血管病学分会, 中国生物医学工程学会心律分会. 心房颤动诊断和治疗中国指南[J]. 中华心血管病杂志, 2023, 51(6):572-618.
[19]	Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)[J]. Eur Heart J, 2021, 42(5):373-498.
[20]	Reddy YNV, Carter RE, Obokata M, et al. A simple, evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction[J]. Circulation, 2018, 138(9):861-870. doi: 10.1161/CIRCULATIONAHA.118.034646 pmid: 29792299
[21]	Aldaas OM, Lupercio F, Darden D, et al. Meta-analysis of the usefulness of catheter ablation of atrial fibrillation in patients with heart failure with preserved ejection fraction[J]. Am J Cardiol, 2021, 142:66-73. doi: 10.1016/j.amjcard.2020.11.039 pmid: 33290688
[22]	von Olshausen G, Benson L, Dahlström U, et al. Catheter ablation for patients with atrial fibrillation and heart failure[J]. Eur J Heart Fail, 2022, 24(9):1636-1646.
[23]	Packer DL, Piccini JP, Monahan KH, et al. Ablation versus drug therapy for atrial fibrillation in heart failure[J]. Circulation, 2021, 143(14):1377-1390.
[24]	Oraii A, McIntyre WF, Parkash R, et al. Atrial fibrillation ablation in heart failure with reduced vs preserved ejection fraction[J]. JAMA Cardiol, 2024, 9(6):545-555.
[25]	Reddy YNV, Borlaug BA, Gersh BJ. Management of atrial fibrillation across the spectrum of heart failure with preserved and reduced ejection fraction[J]. Circulation, 2022, 146(4):339-357. doi: 10.1161/CIRCULATIONAHA.122.057444 pmid: 35877831
[26]	Ariyaratnam JP, Elliott AD, Mishima RS, et al. Identification of subclinical heart failure with preserved ejection fraction in patients with symptomatic atrial fibrillation[J]. JACC Heart Fail, 2023, 11(11):1626-1638.
[27]	Rattka M, Pott A, Kühberger A, et al. Restoration of sinus rhythm by pulmonary vein isolation improves heart failure with preserved ejection fraction in atrial fibrillation patients[J]. Europace, 2020, 22(9):1328-1336. doi: 10.1093/europace/euaa101 pmid: 32449907
[28]	von Roeder M, Blazek S, Rommel KP, et al. Changes in left atrial function in patients undergoing cardioversion for atrial fibrillation: relevance of left atrial strain in heart failure[J]. Clin Res Cardiol, 2022, 111(9):1028-1039.
[29]	Chieng D, Sugumar H, Segan L, et al. Atrial fibrillation ablation for heart failure with preserved ejection fraction[J]. JACC Heart Fail, 2023, 11(6):646-658.
[30]	Tamargo M, Obokata M, Reddy YNV, et al. Functional mitral regurgitation and left atrial myopathy in heart failure with preserved ejection fraction[J]. Eur J Heart Fail, 2020, 22(3):489-498. doi: 10.1002/ejhf.1699 pmid: 31908127
[31]	Yamauchi R, Morishima I, Okumura K, et al. Association between catheter ablation for nonparoxysmal atrial fibrillation and functional mitral regurgitation in patients with heart failure with preserved ejection fraction[J]. Am J Cardiol, 2023, 207:192-201. doi: 10.1016/j.amjcard.2023.08.154 pmid: 37742539
[32]	Soulat-Dufour L, Lang S, Addetia K, et al. Restoring sinus rhythm reverses cardiac remodeling and reduces valvular regurgitation in patients with atrial fibrillation[J]. J Am Coll Cardiol, 2022, 79(10):951-961. doi: 10.1016/j.jacc.2021.12.029 pmid: 35272799
[33]	Redfield MM, Borlaug BA. Heart failure with preserved ejection fraction[J]. JAMA, 2023, 329(10):827-838.
[34]	Johner N, Namdar M, Shah DC. Right atrial complexity evolves with stepwise left-sided persistent atrial fibrillation substrate ablation and predicts outcomes[J]. JACC Clin Electrophysiol, 2020, 6(13):1619-1630. doi: 10.1016/j.jacep.2020.06.021 pmid: 33334439
[35]	Nakatani Y, Sridi-Cheniti S, Cheniti G, et al. Pulsed field ablation prevents chronic atrial fibrotic changes and restrictive mechanics after catheter ablation for atrial fibrillation[J]. Europace, 2021, 23(11):1767-1776. doi: 10.1093/europace/euab155 pmid: 34240134
[36]	Brignole M, Pentimalli F, Palmisano P, et al. AV junction ablation and cardiac resynchronization for patients with permanent atrial fibrillation and narrow QRS[J]. Eur Heart J, 2021, 42(46):4731-4739. doi: 10.1093/eurheartj/ehab569 pmid: 34453840
[37]	Zhang JF, Pan YW, Li J, et al. Comparison of His-Purkinje conduction system pacing with atrial-ventricular node ablation and pharmacotherapy in HFpEF patients with recurrent persistent atrial fibrillation (HPP-AF study)[EB/J]. Cardiovasc Drugs Ther, 2023. https://link.springer.com/article/10.1007/s10557-023-07435-2.
[38]	Khan MN, Jaïs P, Cummings J, et al. Pulmonary-vein isolation for atrial fibrillation in patients with heart failure[J]. N Engl J Med, 2008, 359(17):1778-1785.