Key result
Catheter ablation is superior to pharmacologic therapy for the management of symptomatic atrial fibrillation in patients with heart failure with reduced ejection fraction.
Why the study?
Atrial arrhythmias are common in HFrEF, motivating a review of management options and emerging clinical data supporting catheter ablation.
Does catheter ablation improve outcomes compared to pharmacologic therapy in patients with HFrEF and symptomatic atrial fibrillation?
Does catheter ablation improve outcomes compared to pharmacologic therapy in patients with HFrEF and symptomatic atrial fibrillation?
A rhythm control strategy, preferably with catheter ablation, should be strongly considered for maintaining sinus rhythm in patients with HFrEF and symptomatic atrial fibrillation.
PURPOSE OF REVIEW: Atrial arrhythmias are common among individuals with heart failure with a reduced ejection fraction (HFrEF). This review describes management options for these arrhythmias and discusses emerging clinical data supporting catheter ablation. RECENT FINDINGS: Several recent clinical trials indicate that catheter ablation is superior to pharmacologic therapy for management of symptomatic atrial fibrillation in the setting of HFrEF. Restoration and maintenance of sinus rhythm appears to have the greatest benefit with regard to ejection fraction improvement among individuals with a nonischemic heart failure etiology and minimal left ventricular fibrosis. SUMMARY: A rhythm control strategy should be strongly considered in patients with HFrEF, especially when the atrial arrhythmia is symptomatic or is present at the time of a heart failure diagnosis. Catheter ablation may be the preferred strategy for maintenance of sinus rhythm in this patient population.
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Dewland et al. (2020) conducted a review in Atrial arrhythmias in heart failure with a reduced ejection fraction (HFrEF). Catheter ablation vs. Pharmacologic therapy was evaluated. Catheter ablation is superior to pharmacologic therapy for the management of symptomatic atrial fibrillation in patients with heart failure with reduced ejection fraction.
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