Long-term AF recurrence after catheter ablation in AF and HFpEF
Catheter ablation has been shown to be safe and feasible in patients with AF and HFpEF. However, the long-term successful rate is controversial among studies, varying from 45% to 94.8%14-17, which mainly depends on different characteristics of the study population, different definitions of HFpEF, different ablation strategies, and different follow-up durations. Machino-Ohtsuka et al14 revealed that multiple-procedure drug-free success rate at 3 years was only 45%. In the present study, 56 (78.9%) patients in catheter ablation group maintained sinus rhythm after multiple procedures during 31.8-month follow-up. We believe that this discrepancy is attributed to following factors: i) almost 70% of patients were persistent or long-standing persistent AF in Machino-Ohtsuka’s study, while the proportion was 50% in our study; ii) the ablation technique employed in the present study was contact force-guided, which could improve the durability of ablation lesions.