Meta-analysis reveals contrasting effects of AF ablation in heart failure: Reduced vs. preserved ejection fraction
Canada: In the realm of cardiovascular health, the coexistence of atrial fibrillation (AF) and heart failure (HF) presents a complex clinical challenge, necessitating nuanced treatment approaches. A recent systematic review and meta-analysis have shed light on the differential impact of atrial fibrillation ablation in patients with heart failure, stratified by ejection fraction status.
The study, published in JAMA Cardiology found that patients with heart failure with preserved ejection fraction (HFpEF) did not derive the same benefit from catheter ablation as patients with heart failure with reduced ejection fraction (HFrEF).
"The systematic review and meta-analysis of 12 randomized clinical trials (RCTs) comprising 2465 participants with HF, we found catheter ablation of AF compared with conventional medical therapies was tied to a reduced risk of HF events in patients with reduced ejection fraction, while no benefit was observed in patients with preserved ejection fraction," the researchers reported.
Catheter ablation is associated with reduced heart failure hospitalization and death in select patients with atrial fibrillation (AF) and HFrEF. However, the benefit in patients with HFpEF is uncertain. Therefore, Alireza Oraii, Population Health Research Institute, Hamilton, Ontario, Canada, and colleagues aimed to investigate whether catheter ablation for AF is associated with reduced HF-related outcomes according to HF phenotype.
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