Patients of AF treated with catheter Ablation at lower risk of HF compared to medical therapy

A recent study published in the Heart Rhythm O2 found the critical aspect of atrial fibrillation (AF) treatment - its impact on heart failure (HF) development. Atrial fibrillation, a common heart rhythm disorder, has long been associated with an increased risk of heart failure. However, the question of whether the choice of treatment affects this risk has remained largely unexplored.

The study aimed to compare the incidence of heart failure among AF patients undergoing treatment with anti-arrhythmic drugs (AAD) versus catheter ablation (CA).

Researchers delved into the Optum Clinformatics database to identify AF patients who had previously used an anti-arrhythmic drug. These patients were then divided into two cohorts: one group received catheter ablation, while the other continued with a different anti-arrhythmic drug prescription. The two cohorts were meticulously matched based on various socio-demographic and clinical factors using a propensity score matching technique. To compare the risk of developing heart failure between the two groups, a Cox regression model was employed. Subgroup analyses were conducted considering factors such as race/ethnicity, gender, AF subtype, and CHA2DS2-VASc score.

Following rigorous matching, the study encompassed a substantial cohort of 9,246 patients in each group - AAD and CA. The results were astonishing. Patients who received catheter ablation had a remarkable 57% lower risk of developing heart failure compared to those treated solely with anti-arrhythmic drugs. This significant reduction in risk was consistent across various demographic groups and risk factors. Subgroup analyses revealed that non-Hispanic White, non-Hispanic Black, Hispanic, and Asian patients all experienced substantially lower heart failure risk when treated with catheter ablation compared to anti-arrhythmic drugs. This finding held true for different sexes, AF subtypes, and CHA2DS2-VASc scores.

This research unequivocally demonstrates that AF patients undergoing catheter ablation face a significantly reduced risk, approximately 57%, of developing heart failure compared to those receiving anti-arrhythmic drugs. Importantly, this lowered risk applies consistently across diverse patient demographics, AF subtypes, and risk profiles.

Reference:

Gruber, M., Iglesias, M., Khanna, R., Zhang, D., & Karim, S. (2023). Heart failure risk in patients with atrial fibrillation treated with catheter ablation versus antiarrhythmic drugs. In Heart Rhythm O2. Elsevier BV. https://doi.org/10.1016/j.hroo.2023.09.009