Introduction
Atrial fibrillation (AF) and heart failure (HF) often coexist and
facilitate the occurrence and aggravate the prognosis of each other
since they share common predisposing factors and pathophysiological
processes1-3. However, the management of patients with
AF and concomitant HF is often challenging1.
Catheter ablation has been a well-established curative therapy for
AF1, 4. In patients with AF and concomitant HF,
catheter ablation has been shown to improve symptoms, exercise capacity,
quality of life, and LVEF5. Recently, studies showed
that catheter ablation were associated with a reduction in all-cause
mortality and HF hospitalization compared with medical treatment in
patients with AF and HFrEF6-8.
As shown in various studies, AF is a more potent and independent
prognostic factor, increasing the mortality and HF hospitalization in
patients with HFpEF compared with HFrEF9, 10. However,
the optimal therapy in patients with AF and HFpEF remains unclear.
Specifically, the impact of catheter ablation for AF and HFpEF has not
been well established. The present study was conducted to compare the
long-term outcomes of catheter ablation and medical treatment in
patients with AF and concomitant HFpEF. The impact of catheter ablation
was also evaluated with multivariable adjustment, propensity score
matching (PSM), and inverse probability of treatment weighting (IPTW).