Heart failure & cardiomyopathiesRandomised controlled trial
Catheter Ablation in End-Stage Heart Failure with Atrial Fibrillation
- Randomised controlled trial
- single-centre
- open-label
- stopped early for efficacy
Authors' conclusion
Among patients with atrial fibrillation and end-stage heart failure, the combination of catheter ablation and guideline-directed medical therapy was associated with a lower likelihood of a composite of death from any cause, implantation of a left ventricular assist device, or urgent heart transplantation than medical therapy alone.
Study context
- Population
- Patients with symptomatic AF and end-stage HF referred for heart transplantation evaluation, Germany
- Participants
- 97 vs 97
- Comparison
- Ablation vs Medical therapy
- Ablationn = 97
- Medical therapyn = 97reference
- Primary endpoint
- Composite of:
- All-cause death
- LV assist device implantation
- Urgent heart transplantation
- Follow-up
- Median 18.0 months (IQR 14.6 to 22.6)
Primary result
As reported in the abstract
Hazard ratio
0.24
95% CI 0.11–0.52
P < 0.001
Events by treatment group
Ablation vs Medical therapy
HR 0.24 (95% CI 0.11–0.52); P < 0.001
Further findings
| Outcome | Ablation | Medical therapy | HR (95% CI) | |
|---|---|---|---|---|
| All-cause death | 6% | 20% | 0.29 (0.12–0.72) | |
| 0.10.31310Hazard ratio (log scale) |
Catheter ablation performed
Safety
events
| Outcome | Ablation | Medical therapy |
|---|---|---|
| Procedure-related complications | 3 | 1 |
Original publication
Catheter Ablation in End-Stage Heart Failure with Atrial Fibrillation. N Engl J Med. Published 27 August 2023. doi:10.1056/nejmoa2306037
Summarised from the published abstract; every number is checked against it