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<p>Atrial fibrillation (AF) ablation is associated with a&#xa0;lower likelihood of death and surgical heart failure (HF) interventions in patients with HF. This effect is mainly driven by reduced all cause and cardiovascular death following ablation. Ablation also results in improved left ventricular (LV) function, decreased AF burden and AF regression. The accumulated evidence contributed substantially to a&#xa0;class&#xa0;1 indication for AF ablation in patients with AF and HF with reduced ejection fraction in the 2023 ACC/AHA/ACCP/HRS guidelines. Risk scores like the CASTLE-HTx risk score may help to identify patients with HF who will particularly benefit from catheter ablation. The absolute benefit of catheter ablation is more pronounced in high-risk patients and is sustained over time. Catheter ablation should be considered as first-line therapy with a&#xa0;definitive class&#xa0;1 indication for many patients with HF, particularly those with advanced HF.</p>

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Katheterablation bei Patienten mit Herzinsuffizienz – wer profitiert?

  • 期刊论文

  • 发表日期：

    2025年1月30日

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  • Leonard Bergau,
  • Vanessa Sciacca,
  • Christian Sohns

摘要

Atrial fibrillation (AF) ablation is associated with a lower likelihood of death and surgical heart failure (HF) interventions in patients with HF. This effect is mainly driven by reduced all cause and cardiovascular death following ablation. Ablation also results in improved left ventricular (LV) function, decreased AF burden and AF regression. The accumulated evidence contributed substantially to a class 1 indication for AF ablation in patients with AF and HF with reduced ejection fraction in the 2023 ACC/AHA/ACCP/HRS guidelines. Risk scores like the CASTLE-HTx risk score may help to identify patients with HF who will particularly benefit from catheter ablation. The absolute benefit of catheter ablation is more pronounced in high-risk patients and is sustained over time. Catheter ablation should be considered as first-line therapy with a definitive class 1 indication for many patients with HF, particularly those with advanced HF.