{"id":"72cb030e6303","type":"article","url":"https://hartvaat.nl/2023/02/16/catheterablatie-verbetert-cv-uitkomsten-bij-af-en-hartfalen-meta-analyse-van-rct/","title":"Catheterablatie verbetert CV-uitkomsten bij AF en hartfalen: meta-analyse van RCT's","title_en":"Catheter ablation improves cardiovascular outcomes in patients with atrial fibrillation and heart failure: a meta-analysis of randomized controlled trials.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["acuut-hartfalen","bloeddrukbehandeling","carvedilol","cerebrovasculair","farmaco-economie","hartkatheterisatie","hartrevalidatie","harttransplantatie","hfpef","hfref","ijzertekort","katheterablatie","laminopathie","myocardinfarct","ouderen","pathfinder-trial","perifeer-vaatlijden","primaire-preventie","sacubitril-valsartan","secundaire-preventie","step-hfpef","supraventriculaire-tachycardie","ventrikelfibrilleren","vrouwen"],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euac173","source_url":"https://doi.org/10.1093/europace/euac173","authors":["Florentina A Simader","James P Howard","Yousif Ahmad","Keenan Saleh","Akriti Naraen","Jack W Samways","Jagdeep Mohal","Rohin K Reddy","Nandita Kaza","Daniel Keene","Matthew J Shun-Shin","Darrel P Francis","Zachary I Whinnett","Ahran D Arnold"],"significance":8,"published":"2023-02-16","source_date":"2023-02-16","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/hfref-hartfalen-met-verminderde-ejectie/","https://hartvaat.nl/kennis/hartfalen/betablokkers-bij-hartfalen/"],"congress":"","summary_en":"This meta-analysis of randomized trials confirmed that catheter ablation for atrial fibrillation in heart failure patients significantly improves cardiovascular outcomes, including reductions in mortality and heart failure hospitalization. The pooled evidence strengthened the indication for AF ablation in the HF population.","created":"2026-07-03T10:30:14Z","updated":"2026-07-03T18:39:00Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse van gerandomiseerde trials bevestigde dat catheterablatie voor AF bij hartfalenpatiënten de cardiovasculaire uitkomsten significant verbetert, inclusief mortaliteit en hartfalenhospitalisatie. Dit positioneert ablatie als belangrijke therapie bij AF-HF.","abstract_original":"AIMS: The effect of atrial fibrillation catheter ablation on cardiovascular outcomes in heart failure is an important outstanding research question. We undertook a meta-analysis of randomized controlled trials comparing ablation to medical therapy in patients with AF and heart failure. METHODS AND RESULTS: We systematically identified all trials comparing catheter ablation to medical therapy in patients with heart failure and atrial fibrillation. The pre-specified primary endpoint was all-cause mortality in trials with at least 2 years of follow-up. The secondary endpoint was heart failure hospitalization. Sensitivity analyses were performed for trials with any follow-up and trials deemed at low risk of bias. Eight trials (1390 patients) were included. Seven hundred and seven patients were randomized to catheter ablation and 683 to medical therapy. In the primary analysis (three trials, n = 977), catheter ablation reduced mortality compared with medical therapy [relative risk (RR): 0.61, 95% confidence interval (CI): 0.44 to 0.84, P = 0.003]. Catheter ablation also reduced heart failure hospitalizations compared with medical therapy (RR: 0.60, 95% CI: 0.49-0.74, P < 0.001). The effect on stroke was not statistically significant (RR: 0.62, 95% CI: 0.28-1.37, P = 0.237). There was low heterogeneity between studies. Sensitivity analyses were consistent with the primary analyses. CONCLUSION: In patients with atrial fibrillation and heart failure, catheter ablation reduces mortality and the occurrence of heart failure hospitalizations."}