Key result
AF catheter ablation reduces mortality and hospitalizations versus medical therapy in HF with LVEF ≥25%.
Why the study?
Management of patients with concurrent atrial fibrillation and heart failure is challenging, and medication options for atrial fibrillation are limited with many side effects leading to low adherence.
Does catheter ablation of atrial fibrillation reduce hospitalizations and death in patients with heart failure?
Does catheter ablation of atrial fibrillation reduce hospitalizations and death in patients with heart failure?
Catheter ablation of atrial fibrillation provides significant prognostic benefits over medical therapy alone in patients with heart failure and an LVEF ≥25%.
May support ablation in HF with LVEF ≥25%; leaves open confirmation from large RCTs before practice change.
Atrial Fibrillation (AF) and Heart Failure (HF) are closely linked to each other, as each can be either the cause of or the result of the other. Successfully treating one of the two entities means laying the basis for treating the other one as well. Management of patients with AF and HF can be challenging and should primarily adhere to available guidelines. Concerning AF, medication is limited and causes many side effects, leading to low medical adherence. Several smaller studies, summarized in a big meta-analysis, provide evidence that ablation of AF in HF patients is crucial for improving quality of life, reducing HF hospitalizations, and reducing death, provided the LVEF is at least 25% or higher. In advanced HF, alternative treatment options (including assist devices, heart transplant) might still be the better option. Early rhythm control should be taken into consideration, as there is evidence that it is associated with better cardiovascular outcome.
No takes yet. Share an insight, caveat, or question.
Derndorfer et al. (2021) conducted a review in Atrial Fibrillation and Heart Failure. Catheter ablation vs. Medical therapy was evaluated. Catheter ablation of atrial fibrillation in heart failure patients improves quality of life, reduces hospitalizations, and lowers mortality compared to medical therapy, provided LVEF is ≥25%.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: