Arrhythmias & electrophysiology
Catheter ablation vs antiarrhythmic therapy for atrial fibrillation in heart failure with preserved ejection fraction
Main finding · All-cause mortalityResult — go to the resultHazard ratio 0.431 95% CI 0.359–0.518Authors' conclusion
In this retrospective study of patients with AF and HFpEF, CA was associated with lower mortality and risk of acute heart failure compared with AAT.
Study context
- Population
- Patients with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF), TriNetX global database, January 2017 to June 2023; prior heart failure with reduced ejection fraction (HFrEF) or crossover excludedmatched cohort n = 3632
- Participants
- 1,959 vs 7,689
- Exposure
- Catheter ablation vs antiarrhythmic therapy
- Catheter ablation (CA)n = 1,959
- AATn = 7,689reference
- Outcome
- All-cause mortality, CVA/TIA and acute HF
Methodological detailspropensity-score matched
- Propensity-score matched
Main finding
All-cause mortality
Hazard ratio
0.431
95% CI 0.359–0.518
P < 0.001
By group
CAvs AAT
HR 0.431 (95% CI 0.359–0.518); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| HFpEFPropensity-score matched cohort | 0.638 (0.550–0.741) | P < 0.001 | |
| Acute HFrEFPropensity-score matched cohort | 0.645 (0.452–0.920) | P = 0.015 | |
| 0.512Hazard ratio (log scale) |
Composite of stroke/TIA
- No difference in composite of cerebrovascular accident/TIA (HR, 95% CI, P)
- HR, 0.935; 95% CI, 0.725-1.207; P = .607
- Propensity-score matched cohort
Original publication
Catheter ablation vs antiarrhythmic therapy for atrial fibrillation in heart failure with preserved ejection fraction. Heart Rhythm. Published 22 October 2024. doi:10.
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