Objective:

To evaluate the safety and long-term efficacy of combined radiofrequency catheter ablation and left atrial appendage closure (RF + LAAC) in patients with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF), in comparison to RF alone.

Approach:

Key Findings:

• The RF + LAAC group had comparable procedural complication rates to RF alone (5.2% vs. 4.2%, p = 0.733).
• The risks of ischemic stroke/TIA were significantly lower in the RF + LAAC group (ARR=4.95%, HR = 0.096, 95%CI:0.012–0.753, p = 0.026).
• Major bleeding events were also significantly lower in the RF + LAAC group (ARR=3.91%, HR = 0.120, 95%CI: 0.015–0.957, p = 0.045).
• HF rehospitalization rates were similar between the two groups (ARR=−0.56%, HR = 1.356, 95%CI: 0.303–6.059, p = 0.690).

Interpretation:

Combined RF + LAAC was associated with lower risks of ischemic stroke/TIA and major bleeding, without an increase in HF rehospitalization compared to RF alone.

Limitations:

• Retrospective design may introduce selection bias.
• Single-center study limits generalizability of findings.

Conclusion:

In patients with AF and HFpEF, combined RF + LAAC was associated with lower risks of ischemic stroke/TIA and major bleeding, without an observed increase in HF rehospitalization, compared with RF alone.

Attribution Notice

This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.