{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:34:03Z","timestamp":1790688843345,"version":"4.1.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":1130,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000764","name":"King's College London","doi-asserted-by":"publisher","award":["King's Prize Fellowship"],"award-info":[{"award-number":["King's Prize Fellowship"]}],"id":[{"id":"10.13039\/501100000764","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research Biomedical Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012147","name":"Royal Brompton and Harefield NHS Foundation Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012147","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000764","name":"King's College London","doi-asserted-by":"publisher","award":["King's Prize Fellowship"],"award-info":[{"award-number":["King's Prize Fellowship"]}],"id":[{"id":"10.13039\/501100000764","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The ARC-HF and CAMTAF trials randomized patients with persistent atrial fibrillation (AF) and heart failure (HF) to early routine catheter ablation (ER-CA) versus pharmacological rate control (RC). After trial completion, delayed selective catheter ablation (DS-CA) was performed where clinically indicated in the RC group. We hypothesized that ER-CA would result in a lower risk of cardiovascular hospitalization and death versus DS-CA in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Overall, 102 patients were randomized (age 60\u2009\u00b1\u200911\u2009years, left ventricular ejection fraction [LVEF] 31\u2009\u00b1\u200911%): 52 to ER-CA and 50 to RC. After 12\u2009months, patients undergoing ER-CA had improved self-reported symptom scores, lower New York Heart Association class (i.e. better functional capacity), and higher LVEF compared to patients receiving RC alone. During a median follow-up of 7.8 (interquartile range 3.9\u20139.9) years, 27 (54%) patients in the RC group underwent DS-CA and 34 (33.3%) patients died, including 17 (32.7%) randomized to ER-CA and 17 (34.0%) randomized to RC. Compared with DS-CA, a strategy of ER-CA exhibited similar risk of all-cause mortality (adjusted hazard ratio [aHR] 0.89, 95% confidence interval [CI] 0.44\u20131.77, p =\u20090.731) and combined all-cause mortality or cardiovascular hospitalization (aHR 0.80, 95% CI 0.43\u20131.47, p =\u20090.467). However, analyses according to treatment received suggested an association between CA and improved outcomes versus RC (all-cause mortality: aHR 0.43, 95% CI 0.20\u20130.91, p =\u20090.028; all-cause mortality\/cardiovascular hospitalization: aHR 0.48, 95% CI 0.24\u20130.94, p =\u20090.031).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with persistent AF and HF, ER-CA produces similar long-term outcomes to a DS-CA strategy. The association between CA as a treatment received and improved outcomes means there is still a lack of clarity regarding the role of early CA in selected patients. Randomized trials are needed to clarify this question.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2714","type":"journal-article","created":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T02:10:10Z","timestamp":1665540610000},"page":"77-86","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Long-Term Outcomes Following Catheter Ablation Versus Medical Therapy in Patients with Persistent Atrial Fibrillation and Heart Failure with Reduced Ejection Fraction"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4225-3693","authenticated-orcid":false,"given":"Rosita","family":"Zakeri","sequence":"first","affiliation":[{"name":"British Heart Foundation Centre for Research Excellence, Faculty of Life Sciences and Medicine, King's College London , London ,","place":["UK"]},{"name":"Royal Brompton and Harefield Hospitals, Guys and St Thomas' NHS Foundation Trust , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Ahluwalia","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Tindale","sequence":"additional","affiliation":[{"name":"Royal Brompton and Harefield Hospitals, Guys and St Thomas' NHS Foundation Trust , London ,","place":["UK"]},{"name":"National Heart and Lung Institute, Imperial College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Omar","sequence":"additional","affiliation":[{"name":"Royal Brompton and Harefield Hospitals, Guys and St Thomas' NHS Foundation Trust , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Packer","sequence":"additional","affiliation":[{"name":"Royal Brompton and Harefield Hospitals, Guys and St Thomas' NHS Foundation Trust , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habib","family":"Khan","sequence":"additional","affiliation":[{"name":"Royal Brompton and Harefield Hospitals, Guys and St Thomas' NHS Foundation Trust , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Baker","sequence":"additional","affiliation":[{"name":"St Bartholomew's Heart Centre , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shohreh","family":"Honarbakhsh","sequence":"additional","affiliation":[{"name":"St Bartholomew's Heart Centre , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Earley","sequence":"additional","affiliation":[{"name":"St Bartholomew's Heart Centre , London 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