Arrhythmias & electrophysiologyMeta-analysis
Long-term effects of catheter ablation vs medical therapy in patients with atrial fibrillation and heart failure: A reconstructed individual patient data meta-analysis
- reconstructed individual patient data meta-analysis
- randomized controlled trials with ≥2 years of follow-up
- aggregate meta-analyses
- Individual time-to-event data reconstructed from published Kaplan-Meier curves
- Cox regression
Authors' conclusion
Across complementary aggregate and reconstructed IPD analyses, CA reduced mortality and HF hospitalizations and improved ventricular function and rhythm outcomes compared with MT in patients with AF and HF.
Study context
- Population
- Patients with atrial fibrillation (AF) and heart failure (HF)7 studies, 51% catheter ablation (CA), mean follow-up ranging from 2 to 7.8 years
- Participants
- 2,117 patients
- Comparison
- CA vs medical therapy (MT)
Pooled result
As reported in the abstract
All-cause mortality
CA vs MTOdds ratio (95% CI)P value
All-cause mortality
0.55(0.42–0.71)
P < 0.01patients with HF with reduced ejection fraction
0.44(0.30–0.65)
P < 0.01Further pooled results
| Outcome | Estimate | P value | |
|---|---|---|---|
| HF events | OR 0.51 (95% CI 0.33–0.77) | P < 0.01 | |
| Composite endpoint | HR 0.77 (95% CI 0.67–0.90) | P < 0.01 | |
| 0.20.5125Ratio (log scale) |
| Outcome | mean difference (95% CI) | P value | |
|---|---|---|---|
| Left ventricular ejection fraction · improved with CA | 6.23% (3.31–9.14) | P < 0.00001 | |
| −50510Difference (linear scale) |
| Outcome | HR | P value |
|---|---|---|
| Reconstructed IPD analyses — CA vs MT · mortality | 0.59 | |
| Reconstructed IPD analyses — CA vs MT · HF hospitalizations | 0.56 | |
| Reconstructed IPD analyses — CA vs MT · composite risk | 0.69 | |
| Reconstructed IPD analyses — CA vs MT · arrhythmia-free survival (greater with CA) | 0.46 |
Original publication
Long-term effects of catheter ablation vs medical therapy in patients with atrial fibrillation and heart failure: A reconstructed individual patient data meta-analysis. Heart Rhythm. Published 12 May 2026. doi:10.1016/j.hrthm.2026.05.006
Summarised from the published abstract; every number is checked against it