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Title:

Catheter ablation for patients with atrial fibrillation and heart failure: insights from the Swedish Heart Failure Registry.

Document type:
Journal Article; Research Support, Non-U.S. Gov't
Author(s):
von Olshausen, Gesa; Benson, Lina; Dahlström, Ulf; Lund, Lars H; Savarese, Gianluigi; Braunschweig, Frieder
Abstract:
AIMS: To investigate the association between catheter ablation for atrial fibrillation (AF) and mortality as well as hospitalization for heart failure (HF) in patients with HF across the ejection fraction (EF) spectrum. METHODS AND RESULTS: Patients with first-time catheter ablation for AF (ablation group) compared to only medical treated AF patients (no ablation group) were identified from the Swedish Heart Failure Registry between 2005 and 2019. The primary outcome (all-cause mortality/first HF hospitalization) was assessed by Cox regression models in a 1:2 propensity score (PS) matched cohort and pre-specified EF subgroups (preserved EF [≥50%], mildly reduced EF [40-49%], reduced EF [< 40%]) of this cohort. A total of 452 patients in the ablation group and 43 766 patients in the no ablation group were identified. After PS matching, 434 patients in the ablation group were compared to 868 patients in the no ablation group. Over a median follow-up of 2.6 years (0.0-14.1 years), catheter ablation was associated with a lower risk of the primary outcome (all-cause mortality/first HF hospitalization) (hazard ratio [HR] 0.78, 95% confidence interval [CI] 0.65-0.94). Results were consistent across all EF subgroups. In HF with preserved EF (HFpEF), catheter ablation was also associated with a lower risk of recurrent HF hospitalization (incidence rate ratio 0.17, 95% CI 0.07-0.42). CONCLUSION: In HF patients across the EF spectrum, catheter ablation for AF was associated with lower risk of the primary outcome (all-cause mortality/first HF hospitalization). This study supports catheter ablation as a treatment option for AF in HF patients, including those with HFpEF.
Journal title abbreviation:
Eur J Heart Fail
Year:
2022
Journal volume:
24
Journal issue:
9
Pages contribution:
1636-1646
Fulltext / DOI:
doi:10.1002/ejhf.2604
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/35779270
Print-ISSN:
1388-9842
TUM Institution:
Klinik und Poliklinik für Innere Medizin I, Kardiologie
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