Catheter ablation and prognosis of AF and HFpEF
Catheter ablation has been shown to be a favorable treatment to improve
the long-term prognosis in patients with AF and HFrEF6,
7. However, the data on the prognostic value of catheter ablation in
patients with AF and HFpEF is limited. Fukui et al18retrospectively included 85 patients with AF and HFpEF (defined as LVEF> 50% and a history of HF hospitalization) and
revealed that RFCA was associated with a reduced HF hospitalization in
HFpEF patients compared with pharmocotherapy. Rattka et al19 demonstrated that PVI with cryoballoon ablation
(CBA) was able to improve the long-term prognosis of patients with HFpEF
using PSM analysis. In the present study, we retrospectively enrolled
131 consecutive patients with AF and concomitant HFpEF according to
current guidelines and found that catheter ablation was an independent
predictor for a reduction in composite endpoint of all-cause death, TE
events and HF hospitalization, which was further confirmed by sensitive
analysis with PSM and IPTW. We believe that these results will support
the catheter ablation in the treatment of AF and HFpEF, although
prospective randomized controlled studies are warranted.