Arrhythmias & electrophysiology
Different Approaches to Atrial Fibrillation Ablation in Heart Failure Patients: Temporal Trends and Clinical Outcomes
Authors' conclusion
Catheter ablation is associated with significant improvements in systolic function, irrespective of the ablation strategy used. The use of PVI+L/LVA in HFrEF patients is progressively expanding over time. Although the benefits of this practice remain unproven, it is associated with an increased risk of overall and nonvascular complications. These results warrant caution regarding the growing use of PVI+ in HFrEF patients.
Study context
- Population
- Patients with heart failure and reduced ejection fraction (HFrEF) undergoing atrial fibrillation ablationHFrEF patients from 9 international centers
- Participants
- 955 patients
- Exposure
- Pulmonary vein isolation (PVI)+L/LVA vs PVI alone
- Outcome
- Coprimary: ventricular function recovery and atrial fibrillation recurrence-free survival
- Follow-up
- 1 year
Methodological details9 international centers, matched groups, sensitivity analysis for measured confounders
- 9 international centers
- Matched groups
- Sensitivity analysis for measured confounders
Main finding
As reported in the abstract
Free from arrhythmia recurrences at 12 months (overall)
62.3%
Ventricular function recovery at 12 months (overall)
65.4%
Observational data: associations, not effects.
Further findings
Use of PVI+L/LVA over time · 2013 to 2022
- 2013
- 27%
- 2022
- 68%
Safety
Complications
- Complications: P = 0.018
Original publication
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