The Anatolian Journal of Cardiology
Meta Analysis

Catheter Ablation Versus Medical Therapy for Atrial Fibrillation in Patients with Heart failure: A Meta-Analysis of Randomized Controlled Trials

1.

School of Medicine, Shaoxing University, Shaoxing City, Zhejiang Province, China

2.

Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing City, Zhejiang Province, China

3.

Loma Linda University School of Public Health, Loma Linda, CA, USA

4.

Department of Geriatrics, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing City, Zhejiang Province, China

5.

Department of Anesthesiology, Shaoxing Yuecheng People's Hospital, Shaoxing, China

Anatol J Cardiol 2022; 26: 685-695
DOI: 10.5152/AnatolJCardiol.2022.1826
Read: 99 Downloads: 45 Published: 01 September 2022

Background: The optimal treatments for atrial fibrillation in heart failure patients are controversial. The present study compared the efficacy of catheter ablation and medical therapy in patients with atrial fibrillation and heart failure.

Methods: Pubmed, Embase, Cochrane Library, and Web of Science were searched until January 15, 2022. Randomized controlled trials comparing catheter ablation for atrial fibrillation with medical therapy in patients with atrial fibrillation and heart failure were enrolled. Primary outcome was all-cause mortality. Secondary outcomes included the heart failure hospitalization and the change in left ventricular ejection fraction, 6-minute walk test distance, peak oxygen consumption, and Minnesota Living with Heart Failure questionnaire score.

Results: Totally 8 randomized controlled trials involving 1693 patients were included. Compared with medical therapy, catheter ablation significantly reduced all-cause mortality (risk ratios=0.60, 95% Cl: 0.45 to 0.80, P < .001) and hospitalization due to heart failure (risk ratios=0.58, 95% Cl: 0.46 to 0.73, P < .001), improved left ventricular ejection fraction (mean difference=5.25%, 95% CI: 2.78% to 7.71%, P < .001), improved the performance of 6-minute walk test (mean difference=28.83 m, 95% CI: 8.61 to 49.05 m, P=.005), increased peak oxygen consumption (mean difference=3.11 mL/kg/min, 95% CI:  1.04 to 5.18 mL/kg/min, P=.003), and reduced Minnesota Living with Heart Failure score (mean difference=−8.45, 95% CI: −16.28 to −0.62, P=.03).

Conclusion: In heart failure patients with atrial fibrillation, catheter ablation provides more benefits over medical therapy in the important clinical outcomes, exercise capacity, and quality of life.

Cite this article as: Yu Z, Xing Y, Peng J, et al. Catheter ablation versus medical therapy for atrial fibrillation in patients with heart failure: A meta-analysis of randomized controlled trials. Anatol J Cardiol. 2022;26(9):685-695.

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ISSN 2149-2263 EISSN 2149-2271