Highlights
- •The findings of investigations comparing the outcomes of catheter ablation (CA) and medical treatment (MT) for atrial fibrillation (AF) in heart failure (HF) patients are inconsistent.
- •When compared with MT, patients treated with CA showed a lower risk of all-cause death.
- •Patients treated with CA also exhibited a better improvement in left ventricular ejection fraction, a longer 6-minute walking distance, and a higher reduction in the Minnesota living with heart failure questionnaire.
- •This meta-analysis emphasizes the significance of CA in terms of all-cause mortality, as well as including the largest number of participants in this issue.
Abstract
Background
The results of studies comparing the outcomes of catheter ablation (CA) to those of
medical therapy (MT) for atrial fibrillation (AF) in heart failure (HF) patients are
contradictory.
Objectives
Our objective was to conduct a meta-analysis that included randomized controlled trials
(RCTs) that compared these two therapy options for AF in HF patients.
Methods
We searched PubMed, Google Scholar, and the Cochrane Library for eligible studies.
After reviewing all potential studies, we conducted this meta-analysis with the remaining
10 RCTs. We used a modified Jadad scale to assess the publications’ quality, and we
used the Risk of Bias 2 tool to assess the RCTs’ bias risk.
Results
The meta-analysis comprised 2,187 patients. Patients treated with CA had a lower risk
of all-cause mortality than patients treated with MT (RR=0.64 [0.5, 0.82]; p < 0.01). The CA group had greater improvement in left ventricular ejection fraction
(LVEF) than the MT group (mean difference [MD]=5.38 [1.80, 8.97]; p < 0.01). Patients in the CA group had longer 6-min walking distances than patients
in the MT group (MD=20.3 [−4.37, 44.9], p < 0.01). Compared to the MT group, the CAD group demonstrated a greater reduction
in scores on the Minnesota Living with Heart Failure Questionnaire (MD= −9.59 [−16.72,
−2.45], p < 0.01).
Conclusion
This meta-analysis highlights the importance of CA in terms of all-cause mortality
and includes the highest number of patients of any study on this topic. Moreover,
compared to MT, CA therapy is associated with greater improvements in LVEF and quality
of life.
Keywords
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Article info
Publication history
Published online: September 07, 2022
Accepted:
August 20,
2022
Received in revised form:
August 12,
2022
Received:
April 24,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
