Study Shows Procedure Can Reverse Detrimental Effects of Heart Failure

MURRAY, UT – A new study by researchers at Intermountain Medical Center’s Heart Institute shows that using catheter ablation to aggressively treat atrial fibrillation in heart failure patients significantly reduces their risk of future heart failure hospitalizations, mortality, stroke, and the development of dementia.

Researchers found that many detrimental effects of heart failure could be reversed in these patients by treating atrial fibrillation with the ablation procedure that involves delivering highly focused heat or radio frequency energy to specific areas of the heart to correct faulty electrical pathways.

Results of the study were presented today at the Heart Rhythm Society’s 32nd Annual Scientific Sessions in San Francisco.

For the study, researchers followed 100 atrial fibrillation patients with moderate to severe left ventricular failure who underwent ablation and compared their symptoms over a three-year period to a control group of heart failure patients who did not have atrial fibrillation. In looking at five potential outcomes — death, hospitalization for heart failure, dementia, stroke and use of an implantable cardioverter defibrillator — researchers discovered that within three years of being treated with ablation, it was almost as if patients treated by ablation never had atrial fibrillation in the first place.

“The good news is that ablation can help prevent the rapid decline in heart failure patients with atrial fibrillation, and we now have a strategy that can help reverse those detrimental affects,” says John D. Day, MD, cardiologist and director of Intermountain Medical Center Heart Institute’s Heart Rhythm Specialists.

Atrial fibrillation is an irregular heart rhythm that occurs when the heart’s upper chambers beat erratically, causing chambers to pump blood inefficiently. It can cause blood to pool and clot in the chambers, increasing the risk of stroke and heart attack. About three million American adults suffer from the condition. That number is expected to double over the next 25 years.

Living with heart failure can be difficult. The fatigue, weakness, shortness of breath, and other problems require a strict regimen of medications and therapies. And, if you combine heart failure with atrial fibrillation, the effectiveness of those traditional treatments decreases, raising one’s risk of death, stroke, and dementia exponentially.

“More than anything, these findings demonstrate that atrial fibrillation ablation is relatively safe in these high risk patients and that it can improve their long-term outcomes. We are very encouraged by these results,” says Jared Bunch, MD, principal investigator of the study and director of heart rhythm research at the Intermountain Medical Center Heart Institute.

Dr. Bunch noted that increased contact between heart failure patients and their heart specialists following a procedure for atrial fibrillation allows for better monitoring of medications and lifestyle factors that influence a patient’s health. He believes that may have played a role in determining the outcomes of this study.

Researchers say that additional testing is needed to better determine long-term outcomes.

“The next question we need to ask in this case is, ‘Does it matter how atrial fibrillation is treated?’ We need to examine medication therapies for this disorder and compare them with ablation,” says Dr. Day.

All of the patients in this study are participants in the Intermountain Heart Collaborative Study.