Prognostic Factors of Heart Failure Patients with Atrial Fibrillation

Introduction: Atrial fibrillation is associated with an increased mortality of patients in heart failure, however the impact of rhythm control by medical therapy or catheter ablation for these patients has been unknown. Method: This study was a retrospective case-control study of 109 patients who were hospitalized for heart failure with atrial fibrillation from February 2010 to March 2013. Primary endpoints are composite events (all cause death, cardiac death and hospitalization for heart failure) after 3 years. Result: Composite events were occurred in 35 cases (32. 1%) (all cause death: 22 cases (20.2%), cardiac death: 13 cases (12.0%) and hospitalization for heart failure:13 cases (12.0%)). The mean age (80.2±10.8 vs.72.3±10.3: P < .001), creatinine level (1.36±0.85 vs. 1.05±0.43: P = .43) and BNP level after 1 year (475.7±404.8 vs. 194.1±226.3: P < .001) were significantly higher in event (+) group. In univariate analysis for composite events, 65 years or older (OR = 4.95: P = .041) and CKD (OR = 2.38: P = .042) were significant predictors of occurrence of composite events, and catheter ablation (OR = 0.11: P = .034) was associated with a significantly lower risk of composite events. In multivariate analysis, only patients treated by catheter ablation had a significantly lower risk of composite events (OR = 0.12: P = .045). Conclusion: Our study suggests that the catheter ablation atrial fibrillation in patients with heart failure might reduce the cardiac events.