A new study published in the journal Heart Rhythm suggests that catheter ablation, a common treatment for atrial fibrillation, may significantly improve outcomes for people with early-stage transthyretin amyloid cardiomyopathy (ATTR-CM).
Approximately 70% of people with ATTR-CM have atrial fibrillation (a fast, irregular heartbeat), which can complicate the disease and is associated with worsening heart failure. Medications like beta blockers are typically used to treat atrial fibrillation but tend to not be well-tolerated by people with ATTR-CM. Another treatment option is catheter ablation, a minimally invasive procedure that utilizes heat or cold to create small scars on the heart which stop the electrical signals that cause irregular heartbeats. While some studies have shown ablation has successful results for people with ATTR-CM, research is limited.
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The new study included 149 individuals with ATTR-CM and atrial fibrillation from seven medical centers in Japan. Fifty-three of the participants underwent catheter ablation, while the others did not. During a median follow up period of three years, the researchers found that those who had the catheter ablation procedure were significantly less likely to have adverse outcomes (including hospitalization from heart failure, stroke and death) compared to those who did not undergo the procedure.
Furthermore, of the individuals who had ablation, those in the earliest stage of ATTR-CM (representing less severe amyloidosis) had notably fewer recurrences of atrial fibrillation and better long-term outcomes. The researchers noted the benefits of catheter ablation are less clear for people with more advanced stages of ATTR-CM.
While more research is needed to validate these findings and individual treatment decisions should be made in partnership between patient and doctor, the study’s authors say their research suggests catheter ablation appears to be a good option to treat atrial fibrillation in people with ATTR-CM, particularly in early stages of disease.
“Previous research has shown that ATTR-CM patients undergoing ablation had significantly reduced risks of heart failure and death compared to matched controls who did not undergo the procedure,” the researchers wrote. “Our study corroborates these findings, providing further evidence for the efficacy of catheter ablation. In other words, rhythm status after ablation may influence long-term prognosis in patients with ATTR-CM.”
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