Catheter ablation in AF patients with preserved ejection fraction yielded high 1-year AF freedom across HFA-PEFF score groups (86.4%, 91.7%, 89.7%; p=0.66) and remarkably improved HFpEF features.
Cohort (n=127)
Does catheter ablation improve HFA-PEFF scores and maintain AF freedom in AF patients with preserved ejection fraction?
Catheter ablation in AF patients with preserved ejection fraction is associated with significant improvement in HFpEF features as measured by the HFA-PEFF score, suggesting reversibility of HFpEF-like changes.
p-value: p=0.66
ABSTRACT Background Atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) often coexist, but the prevalence of HFpEF among AF patients undergoing catheter ablation (CA) remains unclear. Methods We studied 127 AF patients with preserved ejection fraction (≥ 50%) undergoing initial CA. The Heart Failure Association Pre‐test assessment, Echocardiography and natriuretic peptides, Functional testing, and Final etiology (HFA‐PEFF) score was assessed 2 weeks before and 1 year after CA. Patients were grouped as low (0–1), intermediate (2–4), or high (5–6). The primary endpoint was AF freedom at 1 and 2 years; secondary endpoints were changes in HFA‐PEFF score; tertiary endpoint was predictors of score improvement. Results Of 127 patients, 30 (23.6%) had HFpEF (score ≥ 5), 76 (59.8%) suspected (2–4), and 21 (16.5%) unlikely (≤ 1). Median follow‐up 24.4 12.5–29.5 months. AF freedom at 1 year was high (86.4%, 91.7%, 89.7%; p = 0.66). Higher baseline score correlated with older age, female sex, hypertension, larger left atrial volume index (LAVI), elevated average E / e ′, and increased left ventricular mass index. We divided patients into two groups: those with ≥ 1‐point score improvement after CA ( n = 89, 70.1%) and those whose score remained unchanged or worsened ( n = 38, 29.9%). Improvement was associated with older age, larger LAVI, higher average E / e ′, and elevated N‐terminal pro‐B‐type natriuretic peptide. Multivariate analysis identified septal e' and LAVI as predictors. No patients had a score ≥ 5 at 1 year. Conclusions HFpEF or suspected HFpEF was common in AF CA candidates but not linked to recurrence. CA remarkably improved HFpEF features, suggesting reversibility.
Sawada et al. (Mon,) conducted a cohort in Atrial fibrillation with preserved ejection fraction (n=127). Catheter ablation vs. Low (0-1), intermediate (2-4), and high (5-6) HFA-PEFF score groups was evaluated on AF freedom at 1 and 2 years (p=0.66). Catheter ablation in AF patients with preserved ejection fraction yielded high 1-year AF freedom across HFA-PEFF score groups (86.4%, 91.7%, 89.7%; p=0.66) and remarkably improved HFpEF features.