The Comprehensive Arrhythmia Research and Management (CARMA) Center, Division of Cardiovascular Medicine, University of Utah Health Sciences Center, 30 North 1900 East, Room 4A100, Salt Lake City, UT, 84132-2400, USA.
Curr Cardiol Rep. 2019 Feb 21;21(2):10. doi: 10.1007/s11886-019-1093-0.
Atrial fibrillation (AF) in patients with heart failure and reduced systolic ejection fraction (HFrEF) is common and associated with increased morbidity and mortality, and managing AF in this population has been particularly challenging with sparse data regarding the optimal treatment strategy.
Recent data suggests that rhythm control with catheter ablation can be of particular benefit to patients with coexisting AF and HFrEF. Recent randomized control trials actually suggest that catheter ablation could potentially improve mortality in this particular patient population. This is in stark contrast to the current practice recommendations that reserve catheter ablation for symptomatic AF in the general population. In this paper, we will review the most current randomized controlled studies using catheter ablation in HFrEF patients with the hope to increase awareness of the potential mortality benefits the need for prioritization of catheter ablation in HFrEF patients in the next AF management guidelines.
心力衰竭伴收缩性射血分数降低（HFrEF）患者常发生心房颤动（AF），且与发病率和死亡率增加相关，而该人群的 AF 管理极具挑战性，关于最佳治疗策略的数据有限。
最近的数据表明，导管消融的节律控制对同时存在 AF 和 HFrEF 的患者尤其有益。最近的随机对照试验实际上表明，导管消融可能会降低这一特定患者群体的死亡率。这与目前的实践建议形成鲜明对比，后者将导管消融保留给普通人群中出现症状性 AF 的患者。在本文中，我们将回顾使用导管消融治疗 HFrEF 患者的最新随机对照研究，希望提高对潜在死亡率获益的认识，并在未来的 AF 管理指南中优先考虑对 HFrEF 患者进行导管消融。
