Table 1.
Clinical features of patients included in the selected studies
| Trials (RCT) | ARC‐HF 2013 13 | CAMTAF 2014 12 | AATAC 2016 11 | CASTLE‐AF 2018 6 | AMICA 2019 10 | CABANA HF subgroup 2019 5 | RAFT‐AF 2022 8 | Zakeri 2022 15 | CASTLE‐HTx 2023 14 |
|---|---|---|---|---|---|---|---|---|---|
| Sample size | 52 | 50 | 203 | 363 | 140 | 778 | 411 | 102 | 194 |
| Age, years, mean ± SD | 63 ± 9 | 63 ± 10 | 61 ± 11 | 64 ± 12 | 65 ± 8 | 68 ± 8 | 67 ± 8 | 61 ± 11 | 63 ± 11 |
| Male, n (%) | 45 (87) | 48 (96) | 151 (74) | 311 (86) | 126 (90) | 433 (56) | 353 (86) | 93 (91) | 157 (87) |
| AF type | Persistent AF | Persistent AF | Persistent AF | Paroxysmal, 118 (33); persistent AF, 245 (67) | Persistent AF | Paroxysmal, 246 (32); persistent AF, 532 (68) | Paroxysmal, 30 (7); persistent AF, 381 (93) | Persistent AF | Paroxysmal, 59 (30); persistent AF, 135 (70) |
| AF duration, months | 23 ± 25 | 24 ± 19 | 102 ± 44 | — | — | 13 ± 11 | — | — | 42 ± 54 |
| Cardiac function | NYHA II–III | NYHA II–III | — | NYHA I–IV | NYHA II–III | NYHA II–IV | NYHA II–III | NYHA II–III | NYHA II–IV |
| Hypertension, n (%) | — | 16 (32) | 94 (46) | 265 (73) | 111 (79) | 665 (85.5) | 272 (66) | 33 (32) | — |
| Diabetes, n (%) | — | — | 46 (23) | 110 (30) | 44 (33) | 195 (25.1) | 125 (30) | — | 56 (29) |
| CHD, n (%) | 24 (46) | 13 (26) | 129 (64) | 168 (46) | 70 (50) | 170 (21.9) | 129 (31) | 38 (37) | — |
| Cerebrovascular disease, n (%) | — | — | — | — | — | 79 (10.2) | 39 (9) | — | — |
| COPD, n (%) | — | — | — | — | — | — | 33 (8) | — | — |
| LVEF, %, mean ± SD | 23.5 ± 7.6 | 32.7 ± 10.0 | 29.5 ± 6.7 | 32.0 ± 8.5 | 26.3 ± 9.2 | 55 ± 8.1 | 40.6 ± 14.8 | 30.0 ± 10.1 | 27.0 ± 6.3 |
| LA diameter, mm, mean ± SD | 48 ± 7 | 51 ± 9 | 47 ± 5 | 49 ± 5 | 51 ± 6 | — | 46 ± 6 | 50 ± 7 | 49 ± 7 |
| Intervention group | Ablation | Ablation | Ablation | Ablation | Ablation | Ablation | Ablation | Ablation | Ablation |
| Control group | Medical rate control | Medical rate control | AMIO | Medical rate or rhythm control | Medical rate or rhythm control | Medical rhythm control | Medical rate control, AVN ablation with BIV pacing | Medical rate control | Medical rate or rhythm control |
| Follow‐up, years | 1 | 0.5 | 2 | 3.2 | 1 | 4.0 | 3.1 | 7.8 | 1.5 |
| Primary outcomes | Peak VO2 | LVEF | AF recurrence | All‐cause mortality, HF hospitalization | LVEF | Composite of death, disabling stroke, serious bleeding, or cardiac arrest | All‐cause mortality and HF events | All‐cause mortality | Composite of death from any cause, implantation of a left ventricular assist device, or urgent heart transplantation |
AADs, antiarrhythmic drugs; AF, atrial fibrillation; AMIO, amiodarone; AVN, atrioventricular node; BIV, biventricular; CHD, coronary heart disease; COPD, chronic obstructive pulmonary disease; HF, heart failure; LA, left atrium; LVEF, left ventricular ejection fraction; NYHA, New York Heart Association Classification; VO2, oxygen consumption.