Arrhythmias & electrophysiology
Outcomes of Atrial Fibrillation Ablation in Heart Failure Subtypes
Authors' conclusion
AF recurrence rates after CA were higher in patients with HF compared with those without HF, with patients with HFpEF being at the highest risk of recurrence. Nonetheless, CA was associated with a significant reduction in AF symptoms, AF-related hospitalization, and HF symptoms in most patients irrespective of HF subtypes.
Study context
- Population
- All patients undergoing atrial fibrillation (AF) catheter ablation at a tertiary center, 2013–202180% no Heart Failure (HF), 8% HFrEF, 7% HF with Mildly Reduced Ejection Fraction (HFmrEF), 5% HF with Preserved Ejection Fraction (HFpEF)
- Participants
- 7,020 patients
- Exposure
- AF ablation outcomes by HF subtype
- Outcome
- AF recurrence
- Follow-up
- 3 years
Methodological detailssingle-centre (tertiary center)
- Single-centre (tertiary center)
Main finding
As reported in the abstract
Cumulative incidence of AF recurrence after ablation
Each group vs no HFHazard ratio (95% CI)P value
HFpEF
1.47(1.21–1.78)
P < 0.05HFmrEF
1.23(1.04–1.45)
P < 0.05HFrEF
1.17(1.01–1.37)
P < 0.05Observational data: associations, not effects.
Secondary outcomes
| Outcome | No HF | HFrEF | HFmrEF | HFpEF |
|---|---|---|---|---|
| AF-related hospitalization, mean rate per 1 patient-year, before vs after CA | ||||
| Before CA | 1 | 1.1 | 1.1 | 1.8 |
| After CA | 0.1 | 0.2 | 0.2 | 0.3 |
- AF-related hospitalization, mean rate per 1 patient-year, before vs after catheter ablation (CA) — Significant reduction in all groups
- P<0.01 for each comparison
Quality of life (AF symptom severity score and AF burden score), baseline vs follow-up
- Significant improvement in all groups for each score
- P < 0.01
Original publication
Outcomes of Atrial Fibrillation Ablation in Heart Failure Subtypes. Circ Arrhythm Electrophysiol. Published 28 August 2024. doi:10.
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