Major findings
This study demonstrated the following key findings. Firstly, catheter ablation was significantly associated with a lower incidence of the composite endpoint of all-cause death, TE events and HF hospitalization in AF and concomitant HFpEF. Secondly, remarkable reduction in AF recurrence was observed with contact force-guided ablation compared with medical treatment. Thirdly, catheter ablation was an independent predictor of improved HF symptoms and reverse atrial remodeling. To the best of our knowledge, this is the first study making a direct comparison of the long-term impact of RFCA to medical treatment on clinical and functional outcomes in patients with HFpEF and AF.