Catheter Ablation of Atrial Fibrillation in Patients with Heart Failure: Focus on the Latest Clinical Evidence

Atrial fibrillation and heart failure are two common cardiovascular conditions that frequently coexist, and it has been widely demonstrated that in patients with chronic heart failure, atrial fibrillation is associated with a significant increase in the risk of all-cause death and all-cause hospital...

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Bibliographic Details
Published in:Journal of clinical medicine 2024-08, Vol.13 (17), p.5138
Main Authors: Demarchi, Andrea, Casula, Matteo, Annoni, Ginevra, Foti, Marco, Rordorf, Roberto
Format: Article
Language:English
Subjects:
Ablation
Beta blockers
Cardiac arrhythmia
Cardiomyopathy
Cardioversion
Catheters
Clinical outcomes
Ejection fraction
Heart failure
Heart rate
Hospitalization
Hypertension
Mortality
Sinuses
Stroke
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Summary:Atrial fibrillation and heart failure are two common cardiovascular conditions that frequently coexist, and it has been widely demonstrated that in patients with chronic heart failure, atrial fibrillation is associated with a significant increase in the risk of all-cause death and all-cause hospitalization. Nevertheless, there is no unanimous consensus in the literature on how to approach this category of patients and which therapeutic strategy (rhythm control or frequency control) is the most favorable in terms of prognosis; moreover, there is still a lack of data comparing the different ablative techniques of atrial fibrillation in terms of efficacy, and many of the current trials do not consider current ablative techniques such as high-power short-duration ablation index protocol for radiofrequency pulmonary vein isolation. Eventually, while several RCTs have widely proved that in patients with heart failure with reduced ejection fraction, ablation of atrial fibrillation is superior to medical therapy alone, there is no consensus regarding those with preserved ejection fraction. For these reasons, in this review, we aim to summarize the main updated evidence guiding clinical decision in this complex scenario, with a special focus on the most recent trials and the latest meta-analyses that examined the role of catheter ablation (CA) in rhythm control in patients with AF and HF.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13175138