Key result
Heart failure with preserved ejection fraction was associated with more extensive low-voltage zones but similar arrhythmia recurrence rates compared to non-HFpEF (12.8% vs. 13.6%, p=0.310).
Why the study?
Does the presence of HFpEF affect the extent of low-voltage zones and arrhythmia recurrence in patients undergoing first-time atrial fibrillation ablation?
Cohort (n=128)
Does the presence of HFpEF affect the extent of low-voltage zones and arrhythmia recurrence in patients undergoing first-time atrial fibrillation ablation?
Absolute Event Rate: 12.8% vs 13.6%
p-value: p=0.310
Patients with HFpEF undergoing AF ablation exhibit more extensive atrial remodeling (low-voltage zones) but have similar short-term arrhythmia recurrence rates compared to those without HFpEF.
BACKGROUND: Atrial fibrillation (AF) frequently coexists with heart failure with preserved ejection fraction (HFpEF), and low-voltage zones (LVZs) in the atria represent atrial remodeling. However, the impact of HFpEF on the extent and distribution of LVZs and ablation outcomes remains unknown. OBJECTIVE: To characterize LVZs in patients with HFpEF undergoing AF ablation and evaluate their association with arrhythmia recurrence. METHODS: A total of 128 consecutive patients (66±12 years) who underwent AF ablation for the first time were retrospectively analyzed. HFpEF was defined as a left ventricular ejection fraction >50% with a history of heart failure treatment or an HFA-PEFF score ≥5. Meanwhile, LVZs were defined as bipolar voltage <0.5 mV and quantified across five left atrial regions. RESULTS: , p < 0.001). During 9±4 months, arrhythmia recurrence rates did not differ significantly between HFpEF and non-HFpEF groups (12.8% vs. 13.6%, p = 0.310). Posterior wall isolation was more frequently performed in the HFpEF group (27.6% vs. 4.9%, p < 0.001). In multivariable analysis, HFpEF, age, and persistent AF were independent determinants of LVZ extent. CONCLUSIONS: AF patients with HFpEF exhibit more extensive LVZs, indicating advanced atrial remodeling. Despite differences in atrial substrate and ablation strategy, arrhythmia recurrence rates were comparable between patients with and without HFpEF.
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Tamura et al. (2026) conducted a cohort in Atrial fibrillation and heart failure with preserved ejection fraction (n=128). Heart failure with preserved ejection fraction (HFpEF) vs. Non-HFpEF was evaluated on Arrhythmia recurrence (p=0.310). Heart failure with preserved ejection fraction was associated with more extensive low-voltage zones but similar arrhythmia recurrence rates compared to non-HFpEF (12.8% vs. 13.6%, p=0.310).
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