In which patients with heart failure should ablation of atrial fibrillation not be performed?
Hitoshi HachiyaPublished in: Journal of cardiovascular electrophysiology (2023)
Catheter ablation of atrial fibrillation (AF) in patients with heart failure associated with a reduced EF (HFrEF) was associated with a significantly lower rate of a composite endpoint of death from any cause or hospitalization for worsening heart failure (HF) than medical therapy in the CASTLE-AF trial. In patients with HF and also with a preserved EF (HFpEF), AF is known to be associated with increased mortality. Although the particular benefit in patients with an EF >35% may suggest the need for prospective randomized control trial data in patients with HF to assess the role of ablation as a first-line therapy as Sessions AJ, et al. stated, we believe at present that 1) whether there is structural heart disease detected by cardiac images and 2) whether the left atrial voltage is generally low, should be assessed "before ablation" in each patient with HF to achieve a successful ablation. This article is protected by copyright. All rights reserved.
Keyphrases
- catheter ablation
- atrial fibrillation
- left atrial
- heart failure
- left atrial appendage
- acute heart failure
- oral anticoagulants
- direct oral anticoagulants
- phase iii
- percutaneous coronary intervention
- phase ii
- left ventricular
- healthcare
- open label
- clinical trial
- study protocol
- randomized controlled trial
- risk factors
- case report
- pulmonary hypertension
- acute coronary syndrome
- cardiovascular disease
- placebo controlled
- big data