{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:20:50Z","timestamp":1792059650339,"version":"4.4.0"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T00:00:00Z","timestamp":1673913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The prognostic role of catheter ablation of atrial fibrillation (AF) in patients with heart failure (HF) remains uncertain, with guideline recommendations largely based on a single trial. We conducted a meta\u2010analysis of randomized controlled trials (RCTs) assessing the prognostic impact of AF ablation in patients with HF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Electronic databases were searched for RCTs comparing \u2018AF ablation\u2019 versus \u2018other care\u2019 (medical therapy and\/or atrioventricular node ablation with pacing) in patients with HF. Primary endpoints were \u22651\u2010year mortality, HF hospitalization and change in left ventricular ejection fraction (LVEF). Meta\u2010analyses were performed using random\u2010effects modelling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine RCTs (<jats:italic>n<\/jats:italic>\u00a0=\u20091462) met inclusion criteria. Compared to \u2018other care\u2019, AF ablation significantly reduced \u22651\u2010year mortality (relative risk [RR] 0.65; 95% confidence intervals [CI], 0.49\u20130.87) and HF hospitalization (RR 0.64; 95% CI, 0.51\u20130.81). AF ablation demonstrated significantly greater improvement in LVEF (mean difference [MD] 5.4; 95% CI, 4.4\u20136.4), 6\u2010min walk test distance (MD 21.5 meters; 95% CI, 4.6\u201338.4) and quality of life as measured by Minnesota Living with Heart Failure Questionnaire score (MD 7.2; 95% CI, 2.8\u201311.7). Meta\u2010regression analyses showed the beneficial impact of AF ablation on LVEF was significantly blunted by higher prevalence of ischaemic cardiomyopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our meta\u2010analysis demonstrates AF ablation is superior to \u2018other care\u2019 in improving mortality, HF hospitalization, LVEF and quality of life in patients with HF. However, the highly selected study populations in included RCTs and effect modification mediated by etiology of HF suggests these benefits do not uniformly apply across the HF population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.12812","type":"journal-article","created":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T11:21:25Z","timestamp":1673954485000},"page":"129-141","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prognostic benefit of catheter ablation of atrial fibrillation in heart failure: An updated meta\u2010analysis of randomized controlled trials"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7235-3919","authenticated-orcid":false,"given":"Sohaib A.","family":"Virk","sequence":"first","affiliation":[{"name":"Department of Cardiology Concord Repatriation General Hospital  Concord New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karice","family":"Hyun","sequence":"additional","affiliation":[{"name":"Department of Cardiology Concord Repatriation General Hospital  Concord New South Wales Australia"},{"name":"Westmead Applied Research Centre University of Sydney  New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Brieger","sequence":"additional","affiliation":[{"name":"Department of Cardiology Concord Repatriation General Hospital  Concord New South Wales Australia"},{"name":"Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond W.","family":"Sy","sequence":"additional","affiliation":[{"name":"Department of Cardiology Concord Repatriation General Hospital  Concord New South Wales Australia"},{"name":"Faculty of Medicine and Health The University of Sydney  Sydney New South 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