Heart failure & cardiomyopathies
Efficacy of Early Catheter Ablation for Atrial Fibrillation After Admission for Heart Failure
Authors' conclusion
In a nationwide representative real-world cohort, CA for AF within 90 days after admission for HF was associated with improved long-term outcomes, including cardiovascular and HF death in patients with HF and AF.
Study context
- Population
- Patients with heart failure (HF) and atrial fibrillation (AF) hospitalised for worsening HF (JROADHF registry)matched cohort n = 83 per group
- Participants
- 103 vs 2,683
- Exposure
- Early catheter ablation (CA) vs no CA after admission for HF
- Early CAn = 103
- Controln = 2,683reference
- Outcome
- All-cause mortality
Methodological detailspropensity-matched, nationwide registry
- Propensity-matched
- Nationwide registry
Main finding
As reported in the abstract
Early CA vs ControlHazard ratio (95% CI)P value
Crude cohort
0.38(0.24–0.60)
log-rank P < 0.001Matched cohort
0.47(0.25–0.88)
log-rank P = 0.014Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| CV deathEarly CAvs ControlCrude cohort; Gray's test | subdistribution HR 0.28 (95% CI 0.13–0.63) | P < 0.001 | |
| CV deathEarly CAvs ControlMatched cohort; Gray's test | subdistribution HR 0.24 (95% CI 0.08–0.70) | P = 0.006 | |
| HF mortalityEarly CAvs ControlCrude cohort; Gray's test | HR 0.31 (95% CI 0.13–0.75) | P = 0.005 | |
| HF mortalityEarly CAvs ControlMatched cohort; Gray's test | HR 0.28 (95% CI 0.09–0.84) | P = 0.017 | |
| 0.050.21520Ratio (log scale) |
Original publication
Efficacy of Early Catheter Ablation for Atrial Fibrillation After Admission for Heart Failure. JACC Clin Electrophysiol. Published 19 July 2023. doi:10.
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