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.