Key result
Catheter ablation plus AAD linked to ~50% lower MACE vs AAD alone in AF with PH.
Why the study?
While catheter ablation is superior to AAD therapy in select AF populations, outcomes in patients with concurrent pulmonary hypertension remain poorly characterized.
Does catheter ablation plus anti-arrhythmic drug therapy reduce major adverse cardiovascular events and right heart failure in adults with atrial fibrillation and pulmonary hypertension compared to anti-arrhythmic drug therapy alone?
Population
9759 patients in each cohort with AF and PH
Comparison
Catheter ablation plus AAD vs AAD therapy alone
Design
Propensity score-matched retrospective cohort study
Authors
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Supports ablation over AAD in AF with PH; extends randomized evidence to this high-risk population.
Cohort (n=19,518)
Yes
Does catheter ablation plus anti-arrhythmic drug therapy reduce major adverse cardiovascular events and right heart failure in adults with atrial fibrillation and pulmonary hypertension compared to anti-arrhythmic drug therapy alone?
Effect estimate: HR 0.497 (95% CI 0.467-0.528)
p-value: p=<0.001
In patients with atrial fibrillation and pulmonary hypertension, catheter ablation combined with anti-arrhythmic drugs is associated with significantly lower risks of MACE, right heart failure, and mortality compared to anti-arrhythmic drugs alone.
Fahim et al. (2026) conducted a cohort in Atrial fibrillation and pulmonary hypertension (n=19,518). Catheter ablation plus anti-arrhythmic drug (AAD) vs. AAD therapy alone was evaluated on Major adverse cardiovascular events (MACE) (HR 0.497, 95% CI 0.467-0.528, p=<0.001). Catheter ablation plus AAD therapy was associated with a 50% reduction in MACE (HR 0.497; 95% CI 0.467-0.528; p<0.001) compared with AAD therapy alone in AF patients with PH.
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