Heart failure & cardiomyopathies
Catheter ablation for atrial fibrillation in heart failure with reduced ejection fraction patients: A meta-analysis
Authors' conclusion
In this meta-analysis of RCTs of patients with AF and HFrEF, CA was associated with a reduction in HF hospitalization, cardiovascular mortality, and all-cause mortality as well as a significant improvement in LVEF and quality of life.
Study context
- Population
- Patients with atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) (LVEF ≤ 40%)
- Participants
- 1,055 patients6 RCTs
- Comparison
- Catheter ablation (CA) plus medical therapy vs medical therapy alone
- CAn = 530
- Outcome
- Efficacy outcomes
Methodological detailsrandom effects model
- Random effects model
Pooled result
As reported in the abstract
CA vs Medical therapyRelative risk (95% CI)P value
HF hospitalization
0.57(0.45–0.72)
P < 0.01CV mortality
0.46(0.31–0.70)
P < 0.01All-cause mortality
0.53(0.36–0.78)
P < 0.01CA vs Medical therapyMD, % (95% CI)P value
AF burden
−29.8(−43.73% to −15.90%)
P < 0.01Further pooled results
| Outcome | MD (%) (95% CI) | P value | |
|---|---|---|---|
| LVEF | 3.8 (1.6%–6.0%) | P < 0.01 | |
| −50510Difference, % (linear scale) |
| Outcome | MD (points) (95% CI) | P value | |
|---|---|---|---|
| Quality of life (Minnesota Living with HF Questionnaire) | −4.92 (−8.61 to −1.22) | P < 0.01 | |
| −10−505Difference, points (linear scale) |
Original publication
Catheter ablation for atrial fibrillation in heart failure with reduced ejection fraction patients: A meta-analysis. Heart Rhythm. Published 3 May 2024. doi:10.
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