1092 CATHETER ABLATION VERSUS MEDICAL THERAPY OF ATRIAL FIBRILLATION IN PATIENTS WITH HEART FAILURE: AN UPDATED SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

Abstract Background Atrial fibrillation (AF) and heart failure (HF) often coexist syner-gistically contribute to an increased risk of hospitalization, stroke, mortality. Objective: To compare the efficacy catheter ablation (CA) versus medical therapy (MT) in HF patients with AF. Methods Electronic databases were queried for randomized controlled trials (RCTs) CA MT AF HF. Risk ratios (RRs), mean differences (MDs), 95% confidence in-tervals (CIs) measured using Mantel–Haenszel method. Results A total nine RCTs enrolling 2155 met inclusion criteria. Compared MT, led a significant reduction composite all-cause mortality hospitalization (24.6% vs. 37.1%; RR: 0.65 (95% CI: 0.53–0.80); p < 0.0001) (Figure 1), (8.8% 13.6%; 0.51–0.82); = 0.0005), (15.4% 22.4%; (RR: 0.67 0.54–0.82); 0.0001), re-currence (31.8% 77.0%; 0.36 0.24–0.54); cardiovascular (CV) death (4.9% 8.4%; 0.58 0.39–0.86); 0.007). improved left ventricular ejection fraction (MD:4.76% 2.35–7.18); 6 min walk test (MD: 20.48 m 10.83–30.14); peak oxygen consumption 3.1 2mL/kg/min 1.01–5.22); 0.004), Minnesota Living Heart Failure Questionnaire score −6.98 −12–03, −1.93); 0.007), brain natriuretic peptide levels (MD:−133.94 pg/mL −197.33, −70.55); 0.0001). Conclusions In patients, was superior re-ducing CV Further benefits occurred within group terms hospitalizations, recurrences, systolic function, exercise capacity, quality life. Figure 1: Forest plot displaying decrease endpoint undergoing MT.