What question did this study set out to answer?

Assess the association of catheter ablation for atrial fibrillation with mortality and hospitalization across the ejection fraction spectrum in heart failure patients.

July 2, 2022European Journal of Heart Failure

Catheter ablation for patients with atrial fibrillation and heart failure: insights from the Swedish Heart Failure Registry

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Why the study?

Does catheter ablation reduce the composite of all-cause mortality or first HF hospitalization in patients with atrial fibrillation and heart failure?

Key Points

Assess the association of catheter ablation for atrial fibrillation with mortality and hospitalization across the ejection fraction spectrum in heart failure patients.
Evaluated observational cohort data from the Swedish Heart Failure Registry examining patients diagnosed with both heart failure and atrial fibrillation.
Catheter ablation for atrial fibrillation was associated with a lower risk of the primary composite outcome of all-cause mortality or first heart failure hospitalization.
The associated clinical benefits were evident across the entire left ventricular ejection fraction spectrum, including patients with heart failure with preserved ejection fraction (HFpEF).

Structured PICO

Does catheter ablation reduce the composite of all-cause mortality or first HF hospitalization in patients with atrial fibrillation and heart failure?

Population

Patients with atrial fibrillation and heart failure across the ejection fraction spectrum (including HFpEF)

Intervention

Catheter ablation

Outcome

Composite of all-cause mortality or first HF hospitalizationcomposite

Catheter ablation for atrial fibrillation is associated with reduced mortality and heart failure hospitalizations in patients with heart failure, including those with HFpEF.

Implication

Hypothesis-generating for ablation benefit in HF with AF; leaves open confirmation in randomized trials.

Abstract

In HF patients across the EF spectrum, catheter ablation for AF was associated with lower risk of the primary outcome (all-cause mortality/first HF hospitalization). This study supports catheter ablation as a treatment option for AF in HF patients, including those with HFpEF.