Catheter Ablation in Atrial Fibrillation With Differing Heart Failure

A team of researchers led by Yasuyuki Shiraishi evaluated catheter ablation (CA) in patients with atrial fibrillation (AF) and varying degrees of heart failure (HF). According to the article published in Europace, CA was associated with improved quality of life and reduced risk of cardiovascular events compared with medication alone, even in patients with mildly reduced and preserved left ventricular ejection fraction (LVEF).

The retrospective study enrolled patients with AF and clinical HF from an all-comer multicenter registry that required the completion of the Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire at registration and again after 1 year. Among those patients, median duration of AF was 108 days (range, 52-218 days), and 83.4% had LVEF above 35%.

Researchers observed that 75 (14.2%) patients underwent CA for atrial fibrillation within 1 year of their registration. At the 1-year timepoint, 67.2% of the ablation patients exhibited clinically meaningful improvement—an increase of 5 or more in AFEQT Overall Summary score—compared with 47.8% of non-ablation patients (adjusted odds ratio, 2.03; 95% CI, 1.13-3.64; P=.017).

Additionally, the researchers determined that a composite outcome of all-cause mortality, stroke, and HF hospitalization occurred less often in the ablation group compared with the non-ablation group (adjusted hazard ratio, 0.27; 95% CI, 0.09-0.86; P=.027).

Ultimately, the authors advanced that CA was associated with greater quality of life and cardiovascular event outcomes in patients with AF and HF compared with management with medication alone, even in patients whose heart failure was not as severe.

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