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Updated: Aug 6, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

Catheter ablation of atrial fibrillation in patients with heart failure: a trial-level meta-analysis

Antonio Iaconelli1,2, Matteo Busti3, Luca Sensini3

  • 1School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.

European Journal of Heart Failure
|July 16, 2026
PubMed

Insights

Catheter ablation significantly reduces mortality and adverse events in patients with heart failure and atrial fibrillation. This procedure also improves cardiac function and quality of life, offering a promising treatment option.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • Atrial fibrillation (AF) is common in heart failure (HF) patients, potentially worsening symptoms and prognosis.
  • The benefit of catheter ablation in HF patients with AF on guideline-recommended pharmacological therapy (GRPT) remains debated.

Purpose of the Study:

  • To systematically review and meta-analyze randomized controlled trials (RCTs) evaluating catheter ablation for AF in patients with HF.

Main Methods:

  • A systematic search of public databases for RCTs published before March 17, 2025.
  • Outcomes included all-cause and cardiovascular mortality, HF/AF adverse events, left ventricular ejection fraction (LVEF), 6-Minute Walking Distance (6-MWD), and quality of life (MLWHFQ).

Main Results:

  • Thirteen RCTs with 2,490 patients were analyzed; most patients were male and had persistent AF.
  • Catheter ablation, compared to GRPT alone, significantly reduced all-cause mortality (HR: 0.58), cardiovascular death (HR: 0.52), and HF/AF adverse events (HR: 0.69).
  • Improvements were observed in LVEF (+6%), MLWHFQ scores (-12 points), and a trend towards enhanced 6-MWD (+18 meters).

Conclusions:

  • Catheter ablation improved cardiac function, well-being, and mortality outcomes in selected chronic HF and AF patients within un-blinded RCTs.
  • Further RCTs are needed to confirm benefits in broader patient populations, especially those at higher risk for procedural failure.
Abstract

Keywords:
Atrial FibrillationCatheter AblationHeart failure

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