Frontiers in cardiovascular medicine · 2026
Long-term outcome of patients with atrial fibrillation and heart failure with preserved ejection fraction after combined radiofrequency catheter ablation and left atrial appendage closure.
СтатьяНазвание и аннотация: Перевод в очереди
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Che Qian-Ji, Zhang Yi-Chao, Chen Mu, Yao Peng-Cheng, Wang Qun-Shan, Sun Jian, Li Wei, Liu Bo, Zhang Peng-Pai, Yu Yi-Chi, Yang Yu-Li, Yang Mei, Zhang Rui, Li Yi-Gang
Аннотация
BACKGROUND: In patients with heart failure with preserved ejection fraction (HFpEF), further investigation of the safety and long-term efficacy of combined radiofrequency catheter ablation and left atrial appendage closure (RF + LAAC) in patients with HFpEF is warranted.
METHODS: In this retrospective study, we aimed to evaluate the outcome of RF + LAAC in patients with AF and HFpEF, compared to radiofrequency catheter ablation (RF) alone. 331 patients with AF and chronic HFpEF were divided into two groups: RF + LAAC (n = 196) and RF (n = 135). After 1:1 propensity score matching (PSM), 96 matched pairs were enrolled in further analysis. HF rehospitalization, ischemic stroke/transient ischemic attack (TIA), and major bleeding events were assessed over 24 months. Kaplan-Meier analyses were used to compare outcomes.
RESULTS: The RF + LAAC group demonstrated comparable procedural complication rates to RF alone (5.2% vs. 4.2%, p = 0.733). The risks of ischemic stroke/TIA (ARR=4.95%, HR = 0.096, 95%CI:0.012-0.753, p = 0.026) and major bleeding events (ARR=3.91%, HR = 0.120, 95%CI: 0.015-0.957, p = 0.045) were significantly lower in RF + LAAC group vs. RF alone, while HF rehospitalization was similar between the two groups (ARR=-0.56%, HR = 1.356, 95%CI: 0.303-6.059, p = 0.690).
CONCLUSIONS: In patients with AF and HFpEF, combined RF + LAAC was associated with lower risks of ischemic stroke/TIA and major bleeding, without an observed increase in HF rehospitalization, compared with RF alone.
METHODS: In this retrospective study, we aimed to evaluate the outcome of RF + LAAC in patients with AF and HFpEF, compared to radiofrequency catheter ablation (RF) alone. 331 patients with AF and chronic HFpEF were divided into two groups: RF + LAAC (n = 196) and RF (n = 135). After 1:1 propensity score matching (PSM), 96 matched pairs were enrolled in further analysis. HF rehospitalization, ischemic stroke/transient ischemic attack (TIA), and major bleeding events were assessed over 24 months. Kaplan-Meier analyses were used to compare outcomes.
RESULTS: The RF + LAAC group demonstrated comparable procedural complication rates to RF alone (5.2% vs. 4.2%, p = 0.733). The risks of ischemic stroke/TIA (ARR=4.95%, HR = 0.096, 95%CI:0.012-0.753, p = 0.026) and major bleeding events (ARR=3.91%, HR = 0.120, 95%CI: 0.015-0.957, p = 0.045) were significantly lower in RF + LAAC group vs. RF alone, while HF rehospitalization was similar between the two groups (ARR=-0.56%, HR = 1.356, 95%CI: 0.303-6.059, p = 0.690).
CONCLUSIONS: In patients with AF and HFpEF, combined RF + LAAC was associated with lower risks of ischemic stroke/TIA and major bleeding, without an observed increase in HF rehospitalization, compared with RF alone.