Catheter ablation significantly reduced the risk of major adverse cardiac events (HR 0.51) compared to rate control in patients with atrial fibrillation and heart failure.
Cohort (n=394)
Yes
Does catheter ablation reduce major adverse cardiac events compared to rate control in patients with atrial fibrillation and symptomatic heart failure?
In patients with atrial fibrillation and symptomatic heart failure, catheter ablation significantly reduces the risk of major adverse cardiac events compared to a rate control strategy.
Effect estimate: HR 0.51 (95% CI 0.32-0.82)
Absolute Event Rate: 13.3% vs 29.3%
p-value: p=0.005
Many trials have shown improvements in left ventricular function, exercise capacity, and quality of life after catheter ablation (CA) of atrial fibrillation (AF) in patients with heart failure (HF). We sought to evaluate the impact of CA on hard outcomes in a retrospective cohort study. AF patients with symptomatic HF from 3 hospitals were included. Our primary endpoint was major adverse cardiac events (MACEs), a composite of all-cause mortality, stroke, and unplanned hospitalization. In total, 90 patients underwent CA and 304 ones received rate control (RaC) were included. After a mean follow-up of 13.5 ± 5.3 months, 82.2% of patients in CA group got freedom from AF; all patients in RaC group remained in AF. CA group had a significant decreased risk of MACEs compared with RaC group (13.3% vs 29.3%, hazard ratio HR 0.51, 95% confidence interval CI: 0.32-0.82, P = .005). After propensity score matched for confounding factors, difference in MACEs remained significant between groups (13.3% vs 25.6%, HR 0.50, 95% CI: 0.26-0.98, P = .044). Multivariate regression analysis also indicated that CA was significantly associated with a lower risk of MACEs in overall cohort (HR 0.486, 95% CI: 0.253-0.933, P = .030) and in propensity-matched cohort (HR 0.482, 95% CI: 0.235-0.985, P = .045). Besides, age and NYHA class were associated with an increased risk of MACEs. In conclusion, the present study demonstrated that CA for AF in HF patients could reduce the risk of MACEs in a mid-term follow-up. Thus, CA may be a reasonable option for this population.
Geng et al. (Fri,) conducted a cohort in Atrial fibrillation and heart failure (n=394). Catheter ablation vs. Rate control was evaluated on Major adverse cardiac events (MACEs), a composite of all-cause mortality, stroke, and unplanned hospitalization (HR 0.51, 95% CI 0.32-0.82, p=0.005). Catheter ablation significantly reduced the risk of major adverse cardiac events (HR 0.51) compared to rate control in patients with atrial fibrillation and heart failure.
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