Catheter Ablation for Atrial Arrhythmias in Patients With Cardiac Amyloidosis

Nicholas Y. Tan, Yousef Mohsin, David O. Hodge, Martha Lacy, Douglas L Packer, Angela Dispenzieri, Martha Grogan, Samuel J Asirvatham, Malini Madhavan, Christopher J. McLeod

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Background: Cardiac amyloidosis (CA) is associated with increased atrial arrhythmias risk. The efficacy/safety of catheter-based ablation therapy in patients with CA has not been adequately assessed. Methods and Results: All diagnosed CA patients who underwent atrial arrhythmia ablation therapy from 1995 to 2015 were reviewed. Arrhythmia recurrence, NYHA symptoms, and mortality were recorded. A total of 26 patients with CA and atrial arrhythmias were included; there were 7 light-chain (AL), 17 wild-type transthyretin (ATTRwt), and 2 mutated transthyretin (ATTRm) amyloidosis patients in total. Of which 13 underwent atrial arrhythmia ablation (CA-A) and 13 underwent AV nodal ablation (CA-AVN). In the CA-A group, there were: 3 with atrial fibrillation (AF); 6 with atrial flutter (AFL); 2 with AF/AFL; and 2 with atrial tachycardia (AT). One-year and 3-year recurrence-free survival were 75% and 60%, respectively. NYHA symptom improvement 6 months postablation was observed in both CA-A and CA-AVN groups: 7/10 (70%) and 4/8 (50%), respectively. Eleven patients with CA died (8 in CA-AVN group vs. 3 in CA-A group). Conclusions: Catheter-based ablation for patients with CA appears to provide important symptomatic relief. However, mortality from the underlying disease remains a significant issue for the amyloid light-chain subtype.

Original languageEnglish (US)
Pages (from-to)1167-1173
Number of pages7
JournalJournal of Cardiovascular Electrophysiology
Volume27
Issue number10
DOIs
StatePublished - Oct 1 2016

Keywords

  • atrial fibrillation
  • atrial flutter
  • atrial tachycardia
  • AV junctional ablation
  • cardiac amyloidosis
  • catheter ablation
  • pacemaker

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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