Key result
Atrial flutter ablation in HFrEF is linked to ~28% lower 1-year mortality and HF readmission.
Why the study?
No studies have assessed the impact of atrial flutter ablation on clinical outcomes in patients with concurrent heart failure.
Does catheter ablation for atrial flutter reduce the composite of all-cause mortality and heart failure readmission at 1 year in patients with concurrent heart failure?
Cohort (n=15,952)
Yes
Does catheter ablation for atrial flutter reduce the composite of all-cause mortality and heart failure readmission at 1 year in patients with concurrent heart failure?
Effect estimate: HR 0.72 (95% CI 0.61-0.85)
Absolute Event Rate: 10.7% vs 14.5%
p-value: p=<0.001
Catheter ablation for atrial flutter in patients with HFrEF is associated with significantly lower 1-year mortality and heart failure readmissions, though this benefit was not statistically significant in patients with HFpEF.
May support AFL ablation in HFrEF; extends observational data but leaves open need for RCTs.
BACKGROUND: No studies assessed impact of atrial flutter (AFL) ablation on outcomes in patients with AFL and concurrent heart failure (HF). OBJECTIVES: To assess the effect of AFL ablation on mortality and HF readmissions in patients with AFL and HF. METHODS: This retrospective cohort study identified 15,952 patients with AFL and HF from the 2016-17 Nationwide Readmissions Database. The primary outcome was a composite of all-cause mortality and/or HF readmission at 1 year. Secondary outcomes included HF readmission, all-cause mortality, and atrial fibrillation (AF) readmission at 1 year. Propensity score match (1:2) algorithm was used to adjust for confounders. Cox proportional hazard regression was used to generate hazard ratios. RESULTS: = .065). CONCLUSION: In patients with AFL and HFrEF, AFL ablation was associated with lower mortality and HF readmissions at 1 year. Patients with AFL and HFpEF did not show a similar significant reduction in the primary outcome.
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Jani et al. (2020) conducted a cohort in Atrial flutter and concurrent heart failure (n=15,952). Catheter ablation vs. No ablation was evaluated on Composite of all-cause mortality and/or heart failure readmission at 1 year (HFrEF cohort) (HR 0.72, 95% CI 0.61-0.85, p=<0.001). Catheter ablation of atrial flutter in patients with heart failure with reduced ejection fraction significantly reduced the composite of all-cause mortality and heart failure readmission at 1 year (HR 0.72) compared to no ablation.
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