Catheter ablation for AF in heart failure patients improved quality of life (adjusted OR 2.03; 95% CI 1.13-3.64) and reduced cardiovascular events (adjusted HR 0.27; 95% CI 0.09-0.86).
Cohort (n=530)
Yes
Does catheter ablation improve quality of life and reduce cardiovascular events in patients with atrial fibrillation and heart failure compared to drug therapy alone?
Catheter ablation for atrial fibrillation in patients with heart failure, including those with preserved ejection fraction, is associated with improved quality of life and reduced cardiovascular events compared to drug therapy alone.
Effect estimate: adjusted OR 2.03 (95% CI 1.13-3.64)
Absolute Event Rate: 67.2% vs 47.8%
p-value: p=0.017
AIMS: The usefulness of catheter ablation (CA) for atrial fibrillation (AF) across a broad spectrum of heart failure (HF) patients remains to be established. We assessed the association of CA with both health-related quality of life (QoL) and cardiovascular events among HF patients with reduced and preserved left ventricular ejection fraction (LVEF) in an 'all-comer' outpatient-based AF registry. METHODS AND RESULTS: Of 3303 patients with AF consecutively enrolled in a retrospective multicentre registry that mandated the Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) questionnaire at registration and 1-year follow-up, we extracted data from 530 patients complicating clinical HF. The association between CA and both 1-year change in AFEQT Overall Summary (AFEQT-OS) scores and 2-year composite clinical outcomes (including all-cause death, stroke, and HF hospitalization) was assessed by multivariable analyses. The median duration of AF was 108 days (52-218 days), and 83. 4% had LVEF >35%. Overall, 75 patients (14. 2%) underwent CA for AF within 1-year after registration. At 1-year follow-up, 67. 2% in the ablation group showed clinically meaningful improvements of ≥ 5 points in AFEQT-OS score than 47. 8% in the non-ablation group adjusted odds ratio, 2. 03 95% confidence interval (CI): 1. 13-3. 64, P = 0. 017. Furthermore, the composite endpoint of all-cause death, stroke, and HF hospitalization occurred less frequently in the ablation group than the non-ablation group adjusted hazard ratio, 0. 27 (95% CI: 0. 09-0. 86), P = 0. 027. CONCLUSION: Among AF-HF patients, CA was associated with improved QoL and lower risk of cardiovascular events against drug therapy alone, even for patients with mildly reduced and preserved LVEF.
Shiraishi et al. (Tue,) conducted a cohort in Atrial fibrillation and heart failure (n=530). Catheter ablation vs. Non-ablation (drug therapy alone) was evaluated on Clinically meaningful improvements of ≥ 5 points in AFEQT-OS score at 1 year (adjusted OR 2.03, 95% CI 1.13-3.64, p=0.017). Catheter ablation for AF in heart failure patients improved quality of life (adjusted OR 2.03; 95% CI 1.13-3.64) and reduced cardiovascular events (adjusted HR 0.27; 95% CI 0.09-0.86).