Arrhythmias & electrophysiology
Predictors of improvement in heart failure with preserved ejection fraction after catheter ablation in patients with atrial fibrillation
Authors' conclusion
In AF patients with an HFA-PEFF score of 5 or 6, hemoglobin level >13.8 g/dL, LA diameter <46 mm, average E/e' ratio <10.4, and absence of box isolation are independent predictors of HFpEF improvement after AFCA.
Study context
- Population
- Atrial fibrillation (AF) patients with heart failure with preserved ejection fraction (HFpEF) (HFA-PEFF score of 5 or 6 and left ventricular ejection fraction >50%) who underwent initial AFCA between 2015 and 2021AF patients with HFpEF who underwent initial AFCA
- Participants
- 237 participants
- Exposure
- Predictors of HFpEF improvement (decrease in the HFpEF score of 0-4 at 12 months after AFCA), by multivariable logistic regression and receiver operating characteristic analyses
- Outcome
- HFpEF improvement
- Follow-up
- 12 months after AFCA
Main finding
As reported in the abstract
HFpEF improvement observed
90 patients
38%
Observational data: associations, not effects.
Further findings
Predictors of HFpEF improvement
| OR (CI) | P value | ||
|---|---|---|---|
| Hemoglobin level >13.8 g/dLMultivariable logistic regression | 1.70 (1.32–2.18) | P < 0.001 | |
| Left atrial (LA) diameter <46 mmMultivariable logistic regression | 0.92 (0.86–0.98) | P = 0.006 | |
| Average E/e' ratio <10.4Multivariable logistic regression | 0.89 (0.80–0.99) | P = 0.032 | |
| Absence of box isolationMultivariable logistic regression | 4.17 (1.16–14.29) | P = 0.029 | |
| 0.050.21520Odds ratio (log scale) |
Late recurrence of AF
- Late recurrence of AF observed
- 47 patients (19%)
Receiver operating characteristic analyses for optimal cutoff values
- Hemoglobin AUC
- 0.659
- Left atrial (LA) diameter AUC
- 0.629
- Average E/e' ratio AUC
- 0.647
Composite scores incorporating these predictors
- Significantly associated with HFpEF improvement
- P < 0.001
Original publication
Predictors of improvement in heart failure with preserved ejection fraction after catheter ablation in patients with atrial fibrillation. Heart Rhythm. Published 22 May 2025. doi:10.
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