Arrhythmias & electrophysiologyRandomised controlled trial
Optimal Ablation Strategies for Persistent Atrial Fibrillation With Heart Failure: Three-Year Follow-Up of a Prospective Multicenter Randomized Trial
- multicenter, randomized controlled trial
Authors' conclusion
Electrogram-anatomic ablation provides superior long-term rhythm control, reduces cardiovascular events, and improves symptoms in patients with persistent AF and HF, regardless of ejection fraction.
Study context
- Population
- Patients with persistent atrial fibrillation (AF) and heart failure (HF), including HF with reduced ejection fraction (ejection fraction ≤40%) and HF with preserved ejection fraction (ejection fraction >40%)randomized equally, 100 patients in each group
- Participants
- 300 patients
- Comparison
- anatomic-guided ablation, electrogram-guided ablation, and extensive electrogram-anatomic-guided ablation
- anatomic-guided ablationn = 100
- electrogram-guided ablationn = 100
- extensive electrogram-anatomic-guided ablationn = 100
- Primary endpoint
- Coprimary: (1) composite of cardiovascular death or HF-related hospitalization/urgent visit; (2) maintenance of sinus rhythm
- Follow-up
- 36 months
Primary result
As reported in the abstract
Composite end point
Sinus rhythm maintenance
Secondary outcomes
AF burden <1%, New York Heart Association class, 6-minute walk test, NT-proBNP
- Consistent improvements were observed
Subgroups: HF with reduced ejection fraction and HF with preserved ejection fraction
- These trends were consistent in both subgroups
Original publication
Optimal Ablation Strategies for Persistent Atrial Fibrillation With Heart Failure: Three-Year Follow-Up of a Prospective Multicenter Randomized Trial. Circ Arrhythm Electrophysiol. Published 31 March 2026. doi:10.1161/circep.125.014394
Summarised from the published abstract; every number is checked against it