Arrhythmias & electrophysiologySecondary analysis
Effects of Atrial Fibrillation Ablation for Heart Failure With Preserved Ejection Fraction
- Secondary analysis of the CABANA randomised trial
- subgroup analysis
Authors' conclusion
In patients undergoing AF ablation, the presence of underlying HFpEF (either by HFpEF probability or defined by echocardiography) was associated with a larger benefit with AF ablation on clinical outcome, AF recurrence, and functional status.
Study context
- Population
- Patients with atrial fibrillation (AF) and CV risk factors for stroke; high likelihood of heart failure with preserved ejection fraction (HFpEF) = modified H2FPEF score ≥655% high H2FPEF score
- Participants
- 1,763 patients
- Comparison
- AF ablation vs drug therapy, by likelihood of HFpEF
- Primary endpoint
- CV hospitalization or death
Primary result
As reported in the abstract
CV hospitalization or death, AF ablation vs drug therapy, by HFpEF likelihood (modified H2FPEF score ≥6)
High likelihood of HFpEF: HR (95% CI); P
0.82 (0.69-0.98); P = 0.025
Without high likelihood of HFpEF: HR (95% CI); P
1.00 (0.82-1.22); P = 0.987
Further findings
AF recurrence, by HFpEF likelihood
- Greatest ablation effect on AF recurrence with high likelihood of HFpEF
- P for interaction = 0.035
Sensitivity analysis: echocardiographic HFpEF (n = 225)
- Similar treatment interaction
Original publication
Effects of Atrial Fibrillation Ablation for Heart Failure With Preserved Ejection Fraction. JACC Heart Fail. Published 16 April 2025. doi:10.1016/j.jchf.2025.01.029
Summarised from the published abstract; every number is checked against it