Catheter ablation improved ejection fraction in persistent AF patients: a DECAAF-II sub analysis.

Area of Science:

• Cardiology
• Electrophysiology
• Heart Failure Management

Background:

• Atrial fibrillation (AF) is a common arrhythmia, often co-occurring with congestive heart failure (CHF).
• Catheter ablation (CA) is a treatment option for AF, but its efficacy in CHF patients requires further investigation.
• Understanding AF recurrence and impact on left ventricular ejection fraction (LVEF) in different CHF subcategories is crucial.

Purpose of the Study:

• To compare post-ablation AF recurrence and burden between CHF and non-CHF patients.
• To assess changes in LVEF across various CHF subcategories after CA.
• To evaluate the relationship between atrial fibrosis and LVEF improvement post-ablation.

Main Methods:

• Retrospective analysis of the DECAFF-II trial population.
• Comparison of AF recurrence and burden between CHF and non-CHF groups, including CHF subgroups.
• Quantification and comparison of LVEF changes across CHF groups and fibrosis stages.

Main Results:

• No significant differences in AF recurrence or burden were observed between CHF and non-CHF patients post-CA.
• Patients with heart failure with reduced ejection fraction (HFrEF) showed the most significant LVEF improvement (16.66%) after CA.
• LVEF improvement was independent of the stage of atrial fibrosis (P = 0.115).

Conclusions:

• Catheter ablation outcomes for AF are comparable between CHF and non-CHF patients, irrespective of CHF type.
• HFrEF patients benefit most from CA in terms of LVEF improvement.
• Ventricular function enhancement post-ablation appears unrelated to atrial fibrosis in persistent AF.