Table 1: Summary of Observational Studies of AF Ablation in Patients with Heart Failure with Reduced Ejection Fraction (HFrEF).
| Study | Sample size (ablation group) | Comparison arm | Mean LVEF (%) | Follow-up (months) | Single procedure success (%) | Multiple procedure success (%) | Improvement in LVEF (%) | Other comments |
|---|---|---|---|---|---|---|---|---|
| Chen 2004[28] | 377 (94) | Normal LVEF controls | 36 | 14 | 52 | 73 | +5 | Improved QOL |
| Hsu 2004[29] | 116 (58) | Normal LVEF controls | 35 | 12 | 50 | 78 | +22 | Improved QOL, exercise capacity, LV dimensions |
| Tondo 2006[30] | 105 (40) | Normal LVEF controls | 33 | 14 | 55 | 87 | +13 | Improved QOL, exercise capacity |
| Gentlesk 2007[31] | 366 (67) | Normal LVEF controls | 42 | 20 | 55 | 86 | +14 | |
| Efremidis 2008[32] | 13 (13) | – | 36 | 9 | 62 | – | +16 | Improved LV dimensions |
| Nadamanee 2008[33] | 129 (129) | – | 31 | 27 | 58 | 79 | +10 | |
| Lutomsky 2008[34] | 70 (18) | Normal LVEF controls | 41 | 6 | 50 | – | +10 | |
| De Potter 2010[35] | 72 (36) | Normal LVEF controls | 41 | 16 | 50 | 64 | +8 | |
| Choi 2010[36] | 30 (15) | HF treated medically | 37 | 16 | 46 | 73 | +13 | |
| Cha 2011[37] | 368 (111) | Normal LVEF, diastolic dysfunction controls | 35 | 13 | – | 75 | +21 | |
| Anselmino 2013[38] | 196 (196) | – | 40 | 46 | 45 | 62 | +10 | Improved LV dimensions and mitral regurgitation |
| Calvo 2013[39] | 658 (97) | Normal LVEF controls | 40 | 6 | 70 | 83 | +12 | |
| Nedios 2014[40] | 138 (69) | Normal LVEF controls | 31 | 28 | 40 | 65 | +15 | |
| Kosiuk 2014[41] | 73 (73) | – | 37 | 40 | 37 | – | +4 | Reduction in ICD therapies |
| Lobo 2015[42] | 31 (31) | – | 45 | 20 | 51 | 77 | +14 | |
| Bunch 2015[43] | 2403 (267) | Matched HFrEF with AF but ablation; and HFrEF with no AF | 27 | 60 | 39 | – | +16 | Reduction in death and hospitalisation |
| Rillig 2015[44] | 80 (80) | – | 35 | 72 | 35 | 57 | +21 | |
| Kato 2016[45] | 18 (18) | – | 26 | 21 | 11 | 61 | +11 | |
| Yanagisawa 2016[46] | 54 (54) | – | 39 | 6 | 65 | 65 | +10 | Reduction in BNP |
| Ullah 2016[47] | 1273 (171) | Normal LVEF controls | 34 | 43 | 26 | 65 | +12 | Reduction in cardiac death |
BNP = B-type natriuretic peptide; ICD = implantable cardioverter defibrillator; LVEF = left ventricular ejection fraction; QOL = quality of life. Adapted and modified, with permission, from Verma et al.[25]