Patient benefits seen for all-cause mortality, implantation of a left ventricular assist device, or urgent heart transplantation<\/p>\n<\/h3>\n
By Lori Solomon HealthDay Reporter<\/b><\/p>\n
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WEDNESDAY, Aug. 30, 2023 (HealthDay News) — For patients with atrial fibrillation and end-stage heart failure, the combination of catheter ablation and guideline-directed medical therapy is associated with a lower likelihood of a composite of all-cause mortality, implantation of a left ventricular assist device, or urgent heart transplantation compared with medical therapy alone, according to a study published online Aug. 27 in the New England Journal of Medicine<\/em> to coincide with the European Society of Cardiology Congress 2023, held from Aug. 25 to 28 in Amsterdam.<\/p>\n Christian Sohns, M.D., from Universit \u00a4tsklinik der Ruhr-Universit \u00a4t Bochum in Germany, and colleagues assigned patients with symptomatic atrial fibrillation and end-stage heart failure who were referred for heart transplantation evaluation to receive catheter ablation and guideline-directed medical therapy (97 patients) or medical therapy alone (97 patients).<\/p>\n The researchers reported that catheter ablation was performed in 84 percent of the ablation group and in 16 percent of the medical therapy group. After a median follow-up of 18.0 months, a composite of death from any cause, implantation of a left ventricular assist device, or urgent heart transplantation occurred in eight patients in the ablation group and in 29 patients in the medical therapy group (hazard ratio [HR], 0.24; P < 0.001). Death from any cause similarly favored the ablation group (six patients in the ablation group versus 19 patients in the medical therapy group; HR, 0.29). Three patients in the ablation group and one patient in the medical therapy group had a procedure-related complication. The trial was stopped for efficacy by the data and safety monitoring board at one year postrandomization.<\/p>\n Differences in the occurrence of primary end-point events between the trial groups appeared to emerge early and be sustained during follow-up, the authors write. However, consideration for catheter ablation should not postpone listing for transplantation. <\/p>\n Several authors disclosed ties to the pharmaceutical or medical technology industries.<\/p>\n Abstract\/Full Text (subscription or payment may be required)<\/a><\/p>\n