Optimal Ablation Strategies for Persistent Atrial Fibrillation With Heart Failure: Three-Year Follow-Up of a Prospective Multicenter Randomized Trial

Circulation Arrhythmia and Electrophysiology 2026

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Authors: Kaige Li, Xinhua Wang, Mu Qin, Ping Ye, Bing Han, Weifeng Jiang, Yu Zhang, Qidong Zheng, Anjing Ji, Menghe Zhang, Yanzhe Wang, Shaohui Wu
+4 more Ke Xu, Changhao Xu, Xu Liu, Xumin Hou
DOI: 10.1161/circep.125.014394
Cited by: 1
References: 26

Abstract

BACKGROUND: Catheter ablation has been shown to improve prognosis in patients with heart failure (HF) and atrial fibrillation (AF); however, the optimal ablation strategy remains undefined. METHODS: In this multicenter, randomized controlled trial, 300 patients with persistent AF and HF, including both HF with reduced ejection fraction (ejection fraction ≤40%) and HF with preserved ejection fraction (ejection fraction >40%, including mid-range ejection fraction [ejection fraction 41% to 50%]), were enrolled and randomized equally to the anatomic-guided ablation, electrogram-guided ablation, and extensive electrogram-anatomic–guided ablation groups, with 100 patients in each group. The coprimary end points were: (1) the composite of cardiovascular death or HF-related hospitalization/urgent visit within 36 months; and (2) maintenance of sinus rhythm at 36 months. Secondary end points included AF burden

Fields of Study & Subjects

Atrial Fibrillation Management and Outcomes Cardiac Arrhythmias and Treatments Cardiac pacing and defibrillation studies

Publication details

Journal / source
Circulation Arrhythmia and Electrophysiology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Volume
19
Issue
4
Pages
e014394–e014394
Publication date
31 March 2026
Language
EN