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Updated: Feb 6, 2026

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Heart Failure with Preserved Ejection Fraction as a Risk Factor for Atrial Fibrillation Recurrence after Ablation.

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Summary

Heart failure with preserved ejection fraction (HFpEF) significantly increases atrial fibrillation (AF) recurrence after catheter ablation. Patients with persistent AF and HFpEF face the highest risk, necessitating tailored treatment strategies for improved outcomes.

Keywords:
Atrial fibrillationHeart failure with preserved ejection fractionRadiofrequency ablationRecurrence

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Research

Background:

  • Atrial fibrillation (AF) recurrence post-ablation impacts patient prognosis.
  • The influence of heart failure with preserved ejection fraction (HFpEF) on AF recurrence is not well-established.

Purpose of the Study:

  • To investigate the effect of HFpEF on the rate of AF recurrence within one year following catheter ablation.

Main Methods:

  • A cohort of 455 patients undergoing AF ablation was analyzed, comparing 241 in the HFpEF group with 213 in the non-heart failure (non-HF) group.
  • Kaplan-Meier analysis, Cox regression, and propensity score matching (PSM) were employed to assess recurrence rates and identify predictors.

Main Results:

  • The HFpEF group showed significantly higher 1-year AF recurrence rates (25.0% vs. 9.8%, P < 0.001).
  • HFpEF was identified as an independent risk factor for recurrence (HR=1.92), particularly in persistent AF cases.
  • Post-PSM analysis confirmed HFpEF as a sole independent predictor of recurrence (HR=2.42, P=0.017).

Conclusions:

  • HFpEF is a significant independent risk factor for 1-year AF recurrence after ablation.
  • Patients with persistent AF and HFpEF exhibit the highest recurrence risk.
  • Individualized treatment strategies are crucial for optimizing outcomes in these patients.