B-PO01-049 LOW LEFT ATRIAL VOLTAGE PREDICTS IMPROVEMENT IN SYSTOLIC FUNCTION POST ATRIAL FIBRILLATION ABLATION IN PATIENTS WITH SYSTOLIC HEART FAILURE

Abstract

Catheter Ablation of Atrial Fibrillation (AF) in patients with heart failure with reduced ejection fraction (HFrEF) is associated with decrease in all-cause mortality, and improvement in left ventricular ejection fraction (EF). Predictors of EF improvement post-AF ablation is not known. To explore predictors of EF improvement post AF ablation in patients with HFrEF. A retrospective chart review of patients who underwent catheter ablation for AF within last 6 years was performed. Patients undergoing catheter ablation for paroxysmal or persistent AF with EF <45% were included. Baseline clinical information, echo and left atrial (LA) voltage data from EP study at the time of ablation was collected on REDCAP. One-way analysis of variance was used to compare between two groups. Out of 263 patients who underwent catheter ablation, 82 (32%) had HFrEF. The mean age was 59.1±11.4; 27% were female. Median follow-up echo post-ablation was at 175 days (IQR 66, 451). Baseline clinical characteristics and results are shown in the table. Mean baseline EF was 30.1±11.4. Mean improvement in EF after ablation was 17±11.8. As compared to baseline, EF improved by at least 5% in 80% of the patients who underwent ablation. Patients with improved EF had significantly higher average total voltage in the LA compared to patients who had no improvement in EF (1.70±1.16 vs 1.00±0.82, p=0.02*). In the multivariable model, after adjusting for other risk factors, LA average total voltage was significantly higher in the group with improved EF (p=0.04*). In patients with HFrEF undergoing catheter ablation for AF low average left atrial voltage predicted lack of improvement in EF.Tabled 1Baseline characteristics comparison between patients with and without improvement in EFEF Improved (n=51)EF not improved (n=13)P-ValueAge58.7+12.557.3+11.70.71Female13 (25%)3 (23%)0.85Hypertension47 (92%)13 (100%)0.17Diabetes Mellitus15 (29%)3 (23%)0.64Cerebrovascular Accident7 (14%)3 (23%)0.42Coronary Artery disease18 (35%)3 (23%)0.39Baseline EF29.1+11.233.4+12.90.29Average total voltage1.70+1.161.00+0.820.02* Open table in a new tab