Heart failure & cardiomyopathies

Ablation for atrial fibrillation improves the outcomes in patients with heart failure with preserved ejection fraction

EuropacePublished Cohort study

Main findingResult — go to the resultAdjusted hazard ratio 0.55 95% CI 0.37–0.82

Authors' conclusion

Among patients with HFpEF and AF, the strategy of AF ablation to maintain SR was associated with a lower risk of the composite outcome of all-cause death or rehospitalization for worsening heart failure.

Study context

Population
Patients with heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF)
Participants
1,034 patients
Exposure
AF ablation vs medical therapy only
  • Ablationn = 392
  • No ablationn = 642reference
Outcome
Composite of:
  • All-cause death
  • Rehospitalization for worsening HF
Follow-up
Median 39 months
Methodological detailspropensity-score matched
  • Propensity-score matched

Main finding

As reported in the abstract

Adjusted hazard ratio

0.55

95% CI 0.37–0.82

P = 0.003

Ablationvs No ablation
adjusted HR 0.55 (95% CI 0.37–0.82); P = 0.003

Observational data: associations, not effects.

Secondary outcomes

OutcomeAdjusted HR (95% CI)P value
Rehospitalization for worsening HF0.52 (0.34–0.80)P = 0.003
Atrial tachycardia/AF recurrence33% relative decrease0.67 (0.54–0.84)P < 0.001

Original publication

Ablation for atrial fibrillation improves the outcomes in patients with heart failure with preserved ejection fraction. Europace. Published 14 December 2023. doi:10.1093/europace/euad363

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