Table 1.
Study Baseline Characteristics of Patients Included in the Analysis.
| Study | MacDonald et al., 2011 [23] | ARC-HF, 2013 [21] | CAMTAF, 2014 [20] | AATAC, 2016 [19] | CAMERA-MRI, 2017 [24] | CASTLE-AF, 2018 [18] | AMICA, 2019 [13] | CAMERA LATE OUTCOMES, 2020 [22] | CABANA, 2021 [17] | RAFT-AF, 2022 [14] | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Monocentric or multicentric | Multicentric | Multicentric | Monocentric | Multicentric | Multicentric | Multicentric | Multicentric | Multicentric | Multicentric | Multicentric | |
| Comparison | Ablation vs. medical rate control | Ablation vs. medical rate control | Ablation vs. medical rate control | Ablation vs. amiodarone | Ablation vs. medical rate control | Ablation vs. medical rhythm and rate control | Ablation vs. medical rhythm and rate control | Ablation vs. medical rate control | Ablation vs. medical rhythm and rate control | Ablation vs. medical rate control | |
| HF inclusion criteria | NYHA class II or greater and optimal HF treatment for at least 3 months | NYHA class II or greater and optimal HF treatment for at least 1 month | NYHA class II or greater and optimal HF treatment for at least 3 months | NYHA class II to III | NYHA class ≥ II | NYHA class ≥ II | NYHA class II or greater and optimal HF treatment for at least 1 months | NYHA class ≥ II | NYHA class ≥ II | NYHA class II/III HF on optimal guideline directedmedical therapy and elevated NT-proBNP | |
| LVEF inclusion criterion | ≤35% (RNVG) | ≤35% | <50% | <40% | ≤45% | ≤35% | ≤35% | ≤45% | No LVEF inclusion criterion | No LVEF inclusion criterion | |
| Type of AF | Persistent | Persistent | Persistent | Persistent | Persistent | Paroxysmal or persistent | Persistent | Persistent | Paroxysmal or persistent | Paroxysmal or persistent | |
| Patients at randomization, n | Ablation | 22 | 26 | 26 | 102 | 34 | 200 | 104 | 34 | 378 | 214 |
| Drug | 19 | 26 | 24 | 101 | 34 | 197 | 98 | 34 | 400 | 197 | |
| Mean age, years (SD or IQR) | Ablation | 62.3 ± 6.7 | 64 ± 10 | 55 ± 12 | 62 ± 10 | 59 ± 11 | 64 (56–71) | 65 ± 8 | 60.5 ± 10.7 | 68 (62, 73) | 65.9 ± 8.6 |
| Drug | 64.4 ± 8.3 | 62 ± 9 | 60 ± 10 | 60 ± 11 | 62 ± 9.4 | 64 (56–73.5) | 65 ± 8 | 65.5 ± 7.2 | 67 (62, 73) | 67.5 ± 8.0 | |
| LVEF Baseline (SD or IQR), % | Ablation | 36.1 ± 11.9 (MRI) 16.1 ± 7.1 (RNVG) | 22 ± 8 (RNVG) | 31.8 ± 7.7 | 29 ± 5 | 35 ± 9.8 (MRI) | 32.5 (25.0–38.0) | 27.8 ± 9.5 | 36.1 ± 9.6 (MRI) | 55 (50-60) | EF ≤ 45%: 30.1 ± 8.5 EF > 45%: 55.9 ± 6.7 |
| Drug | 42.9 ± 9.6 (MRI) 19.6 ± 5.5 (RNVG) | 25 ± 7 (RNVG) | 33.7 ± 12.1 | 30 ± 8 | 35 ± 9.3 (MRI) | 31.5 (27.0–37.0) | 24.8 ± 8 | 34.6 ± 9.1 (MRI) | 56 (50-62) | EF ≤ 45%: 30.3 ± 9.2 EF > 45%: 54.6 ± 7.3 | |
| Mean baseline 6MWT (SD), meters | Ablation | 317.5 ± 125.8 | 416 ± 78 | NA | 348 ± 111 | 491 ± 147 | NA | NA | NA | NA | 363.1 ± 101.4 |
| Drug | 351.8 ± 117.1 | 411 ± 109 | NA | 350 ± 130 | 489 ± 132 | NA | NA | NA | NA | 344.4 ± 107.1 | |
| Mean baseline VO2 max (SD), mL/kg per min | Ablation | NA | 16.3 ± 5.3 | 22 | NA | NA | NA | NA | NA | NA | NA |
| Drug | NA | 18.2 ± 4.8 | 19.5 | NA | NA | NA | NA | NA | NA | NA | |
| Mean baseline MLHFQ score (SD) | Ablation | 55.8 ± 19.8 | 42 ± 23 | 42 | 52 ± 24 | NA | NA | NA | NA | NA | NA |
| Drug | 59.2 ± 22.4 | 49 ± 21 | 48 | 50 ± 27 | NA | NA | NA | NA | NA | NA | |
| Mean baseline BNP(SD or IQR), pg/mL | Ablation | NA | 412 ± 324 | NA | NA | 266 ± 210 | NA | NA | NA | NA | NA |
| Drug | NA | 283 ± 285 | NA | NA | 256 ± 208 | NA | NA | NA | NA | NA | |
| Follow-up | 6 mo | 12 mo | 6 and 12 mo | 24 mo | 6 mo | 60 mo | 12 mo | 4.0 ± 0.9 years | 48.5 mo | 24 mo |
Note: 6MWT: 6 min walk test; AATAC: ablation versus amiodarone for treatment of atrial fibrillation in patients with congestive heart failure and an implanted ICD; AF: atrial fibrillation; AMICA: atrial fibrillation management in congestive heart failure with ablation; ARC-HF: a randomized trial to assess catheter ablation versus rate control in the management of persistent atrial fibrillation in chronic heart failure; BNP: brain natriuretic peptide; CABANA: catheter ablation vs. antiarrhythmic drug therapy for atrial fibrillation; CAMERA-MRI: catheter ablation versus medical rate control in atrial fibrillation and systolic dysfunction; CAMTAF: a randomized controlled trial of catheter ablation versus medical treatment of atrial fibrillation in heart failure; CASTLE-AF: catheter ablation versus standard conventional therapy in patients with left ventricular dysfunction and atrial fibrillation; HF: heart failure; IQR: interquartile range; LVEF: left ventricular ejection fraction; MLHFQ: Minnesota Living with Heart Failure Questionnaires; mo: months; MRI: magnetic resonance imaging; NA: not available; NYHA: New York Heart Association; RAFT: randomized ablation-Based rhythm control versus rate control; RNVG: radionuclide ventriculography; SD: standard deviation; VO2 max: peak oxygen consumption.