Atrial fibrillation ablation in heart failure patients: new therapeutic hope
Abstract
Atrial fibrillation (AF) and heart failure (HF) are common cardiovascular diseases and their coexistence is associated with a worse prognosis in terms of severity of HF symptoms, AF treatment effectiveness, HF hospitalization, and HF-related mortality. In search of optimal therapeutic solutions for this patient group, the authors of this study review current research on the use AF ablation in patients with HF. Analysis of published literature provides scientific evidence supporting the superiority of catheter ablation over conventional pharmacological management, primarily in terms of reducing mortality in this patients group.
Keywords: atrial fibrillationcatheter ablationheart failure
References
- Benjamin EJ, Muntner P, Alonso A, et al. Heart disease and stroke statistics-2019 update: a report from the American Heart Association. Circulation. 2019; 139(10): e56–e5e528.
- Ling LH, Kistler PM, Kalman JM, et al. Comorbidity of atrial fibrillation and heart failure. Nat Rev Cardiol. 2016; 13(3): 131–147.
- Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021; 42(5): 373–498.
- Vermond RA, Geelhoed B, Verweij N, et al. Incidence of atrial fibrillation and relationship with cardiovascular events, heart failure, and mortality: a community-based study from the Netherlands. J Am Coll Cardiol. 2015; 66(9): 1000–1007.
- Ziff OJ, Carter PR, McGowan J, et al. The interplay between atrial fibrillation and heart failure on long-term mortality and length of stay: Insights from the United Kingdom ACALM registry. Int J Cardiol. 2018; 252: 117–121.
- Kotecha D, Lam CSP, Van Veldhuisen DJ, et al. Heart failure with preserved ejection fraction and atrial fibrillation: vicious twins. J Am Coll Cardiol. 2016; 68(20): 2217–2228.
- Wijesurendra RS, Casadei B. Atrial fibrillation: effects beyond the atrium? Cardiovasc Res. 2015; 105(3): 238–247.
- Smit MD, Moes ML, Maass AH, et al. The importance of whether atrial fibrillation or heart failure develops first. Eur J Heart Fail. 2012; 14(9): 1030–1040.
- Kirchhof P, Camm AJ, Goette A, et al. Early rhythm-control therapy in patients with atrial fibrillation. N Engl J Med. 2020; 383(14): 1305–1316.
- Jaïs P, Cauchemez B, Macle L, et al. Catheter ablation versus antiarrhythmic drugs for atrial fibrillation: the A4 study. Circulation. 2008; 118(24): 2498–2505.
- Oral H, Pappone C, Chugh A, et al. Circumferential pulmonary-vein ablation for chronic atrial fibrillation. N Engl J Med. 2006; 354(9): 934–941.
- Mont L, Bisbal F, Hernández-Madrid A, et al. Catheter ablation vs. antiarrhythmic drug treatment of persistent atrial fibrillation: a multicentre, randomized, controlled trial (SARA study). Eur Heart J. 2014; 35(8): 501–507.
- Wazni OM, Marrouche NF, Martin DO, et al. Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a randomized trial. JAMA. 2005; 293(21): 2634–2640.
- Wazni OM, Dandamudi G, Sood N, et al. Cryoballoon ablation as initial therapy for atrial fibrillation. N Engl J Med. 2021; 384(4): 316–324.
- Musikantow DR, Neuzil P, Petru J, et al. Assessment of catheter ablation or antiarrhythmic drugs for first-line therapy of atrial fibrillation: a meta-analysis of randomized clinical trials. JAMA Cardiol. 2021; 6(6): 697–705.
- Kuck KH, Brugada J, Fürnkranz A, et al. Cryoballoon or radiofrequency ablation for paroxysmal atrial fibrillation. N Engl J Med. 2016; 374(23): 2235–2245.
- Chen YH, Lu ZY, Xiang Y, et al. Cryoablation vs. radiofrequency ablation for treatment of paroxysmal atrial fibrillation: a systematic review and meta-analysis. Europace. 2017; 19(5): 784–794.
- Di Biase L, Diaz JC, Zhang XD, et al. Pulsed field catheter ablation in atrial fibrillation. Trends Cardiovasc Med. 2022; 32(6): 378–387.
- Romero J, Gabr M, Alviz I, et al. Improved survival in patients with atrial fibrillation and heart failure undergoing catheter ablation compared to medical treatment: A systematic review and meta-analysis of randomized controlled trials. J Cardiovasc Electrophysiol. 2022; 33(11): 2356–2366.
- Liang JJ, Callans DJ. Ablation for atrial fibrillation in heart failure with reduced ejection fraction. Card Fail Rev. 2018; 4(1): 33–37.
- Jones DG, Haldar SK, Hussain W, et al. A randomized trial to assess catheter ablation versus rate control in the management of persistent atrial fibrillation in heart failure. J Am Coll Cardiol. 2013; 61(18): 1894–1903.
- Hunter RJ, Berriman TJ, Diab I, et al. A randomized controlled trial of catheter ablation versus medical treatment of atrial fibrillation in heart failure (the CAMTAF trial). Circ Arrhythm Electrophysiol. 2014; 7(1): 31–38.
- Di Biase L, Mohanty P, Mohanty S, et al. Ablation versus amiodarone for treatment of persistent atrial fibrillation in patients with congestive heart failure and an implanted device: results from the AATAC multicenter randomized trial. Circulation. 2016; 133(17): 1637–1644.
- Kuck KH, Merkely B, Zahn R, et al. Catheter ablation versus best medical therapy in patients with persistent atrial fibrillation and congestive heart failure: the randomized AMICA trial. Circ Arrhythm Electrophysiol. 2019; 12(12): e007731.
- Marrouche NF, Brachmann J, Andresen D, et al. Catheter ablation for atrial fibrillation with heart failure. N Engl J Med. 2018; 378(5): 417–427.
- Parkash R, Wells GA, Rouleau J, et al. Randomized ablation-based rhythm-control versus rate-control trial in patients with heart failure and atrial fibrillation: results from the RAFT-AF trial. Circulation. 2022; 145(23): 1693–1704.
- Marrouche NF, Greene T, Dean JM, et al. Efficacy of LGE-MRI-guided fibrosis ablation versus conventional catheter ablation of atrial fibrillation: The DECAAF II trial: Study design. J Cardiovasc Electrophysiol. 2021; 32(4): 916–924.
- Marrouche NF, Wazni O, McGann C, et al. Effect of MRI-guided fibrosis ablation vs conventional catheter ablation on atrial arrhythmia recurrence in patients with persistent atrial fibrillation: the DECAAF II randomized clinical trial. JAMA. 2022; 327(23): 2296–2305.
- Mekhael M, Shan B, Noujaim C, et al. Catheter ablation improved ejection fraction in persistent AF patients: a DECAAF-II sub analysis. Europace. 2023; 25(3): 889–895.
- Kotecha D, Lam CSP, Van Veldhuisen DJ, et al. Heart failure with preserved ejection fraction and atrial fibrillation: vicious twins. J Am Coll Cardiol. 2016; 68(20): 2217–2228.
- Zylla MM, Leiner J, Rahm AK, et al. Catheter ablation of atrial fibrillation in patients with heart failure and preserved ejection fraction. Circ Heart Fail. 2022; 15(9): e009281.
- Rattka M, Kühberger A, Pott A, et al. Catheter ablation for atrial fibrillation in HFpEF patients-A propensity-score-matched analysis. J Cardiovasc Electrophysiol. 2021; 32(9): 2357–2367.
- Packer DL, Piccini JP, Monahan KH, et al. Ablation versus drug therapy for atrial fibrillation in heart failure: results from the CABANA trial. Circulation. 2021; 143(14): 1377–1390.
- Androulakis E, Sohrabi C, Briasoulis A, et al. Catheter ablation for atrial fibrillation in patients with heart failure with preserved ejection fraction: a systematic review and meta-analysis. J Clin Med. 2022; 11(2): 288.
- Gu G, Wu J, Gao X, et al. Catheter ablation of atrial fibrillation in patients with heart failure and preserved ejection fraction: a meta-analysis. Clin Cardiol. 2022; 45(7): 786–793.
- Martin CA, Lambiase PD. Pathophysiology, diagnosis and treatment of tachycardiomyopathy. Heart. 2017; 103(19): 1543–1552.
- Khan MN, Jaïs P, Cummings J, et al. Pulmonary-vein isolation for atrial fibrillation in patients with heart failure. N Engl J Med. 2008; 359(17): 1778–1785.
- Dagres N, Varounis C, Gaspar T, et al. Catheter ablation for atrial fibrillation in patients with left ventricular systolic dysfunction. A systematic review and meta-analysis. J Card Fail. 2011; 17(11): 964–970.
- Sugumar H, Prabhu S, Costello B, et al. Catheter ablation versus medication in atrial fibrillation and systolic dysfunction: late outcomes of CAMERA-MRI study. JACC Clin Electrophysiol. 2020; 6(13): 1721–1731.
- Prabhu S, Costello BT, Taylor AJ, et al. Regression of diffuse ventricular fibrosis following restoration of sinus rhythm with catheter ablation in Patients with atrial fibrillation and systolic dysfunction: a substudy of the CAMERA MRI trial. JACC Clin Electrophysiol. 2018; 4(8): 999–1007.