Key result
Catheter ablation of AF in patients with LVEF <50% had comparable in-hospital AF recurrence (7.1% vs 14.8%, p=0.218) and complications (2.4% vs 9.9%, p=0.130) to LVEF ≥50%.
Why the study?
Randomized clinical trials of interventional treatment for AF in patients with systolic LV dysfunction have demonstrated varying effectiveness and safety of catheter interventions.
Does catheter ablation of atrial fibrillation provide comparable early postoperative efficacy and safety in patients with systolic LV dysfunction (LVEF < 50%) compared to patients with preserved LVEF (≥ 50%)?
Observational (n=123)
Pseudo-randomization (propensity score matching)
Does catheter ablation of atrial fibrillation provide comparable early postoperative efficacy and safety in patients with systolic LV dysfunction (LVEF < 50%) compared to patients with preserved LVEF (≥ 50%)?
Catheter ablation of atrial fibrillation in patients with left ventricular systolic dysfunction has comparable in-hospital safety and efficacy to patients with preserved ejection fraction, while significantly improving early postoperative LVEF.
Catheter ablation evaluation in systolic LV dysfunction remains hypothesis-generating; leaves open randomized confirmation before practice consideration.
Atrial fibrillation (AF) is a significant cause of chronic heart failure development. The results of randomized clinical trials focusing on interventional treatment of AF in patients with systolic left ventricular (LV) dysfunction demonstrate varying effectiveness and safety of catheter interventions. Objective. The main aim of this study is to evaluate the efficacy and safety of catheter ablation of AF in patients with systolic LV dysfunction compared to patients without systolic LV dysfunction. Material and methods. Following “pseudo-randomization” 395 patients who underwent pulmonary vein isolation were divided into 2 groups: the main group (LV ejection fraction < 50%, n = 42) and the comparison group (LV ejection fraction ≥ 50%, n = 81). Results. There was no statistically significant difference between the main group and the comparison group in the frequency of postoperative AF recurrence during hospitalization (7.1% (3) vs. 14.8% (12), p = 0.218), the frequency of intraoperative complications (2.4% vs. 9.9%, p = 0.130), and their structure (p = 0.442). The main group showed an increase in LV ejection fraction by +6.6 ± 7.9% on the 2nd day post-operation (p < 0.001), primarily due to the control of tachysystole and restoration of sinus rhythm in the presence of viable LV myocardium. Conclusion. Interventional treatment of AF in patients with systolic LV dysfunction is comparable in safety and efficacy to outcomes in cases with preserved LV ejection fraction.
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Khuziakhmetov et al. (2025) conducted an observational in Atrial fibrillation with vs. without left ventricular systolic dysfunction (n=123). Catheter ablation (pulmonary vein isolation) in patients with systolic LV dysfunction (LVEF < 50%) vs. Catheter ablation (pulmonary vein isolation) in patients with preserved LV function (LVEF ≥ 50%) was evaluated on Postoperative atrial fibrillation recurrence during hospitalization (p=0.218). Catheter ablation of AF in patients with LVEF <50% had comparable in-hospital AF recurrence (7.1% vs 14.8%, p=0.218) and complications (2.4% vs 9.9%, p=0.130) to LVEF ≥50%.
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