Table 1 Study characteristics of the included randomized controlled trials comparing atrial fibrillation catheter ablation to medical therapy in patients with heart failure and reduced ejection fraction
Study (year) | N (ablation/ medical therapy) | Setting (centers) | Type of AF | Mean follow-up (months) | Heart rhythm assessment modality | Frequency of rhythm monitoring (months) | Ablation technique | Ablation strategy | Medical therapy | Primary Outcome | Qualitya |
|---|---|---|---|---|---|---|---|---|---|---|---|
Khan (2008)[31] | 41/40 | Multi | Persistent 50% Paroxysmal 50% | 6 | Loop recorder | 2, 3, 6 | RF | PVI ± Linear lesions & CFAE | AVN ablation+BiV pacing | Change in LVEF, 6- min walk distance and MLWHF score | Fair |
Macdonald (2010) | 22/19 | Single | Persistent | 6 | 24-h Holter monitor | 3, 6 | RF | PVI ± Linear lesions & CFAE ± CVTI (+ 3 months amiodarone) | Rate control with BB ± Dig | Change in LVEF | Good |
Jones (2013)[30] | 26/26 | Multi | Persistent | 12 | 48-h Holter monitor | 2, 3, 6, 12 | RF | PVI ± Linear lesions ± CFAE ± CVTI | Rate control with BB ± Dig | Change in peak oxygen consumption | Fair |
Hunter (2014)[29] | 26/24 | Single | Persistent | 6 | 48-h Holter monitor | 1, 3, 6 | RF | PVI with CFAE ± Linear lesions ± CVTI | Rate control | Change in LVEF | Good |
Di Biase (2016)[28] | 102/101 | Multi | Persistent | 24 | ICD/CRT-D | 3, 6, 12, 24 (device interrogation) | RF | PVI + LAPWI+ SVCI+ CFAE | Amiodarone | AF recurrence | Good |
Prabhu et al. 2017[34] | 33/33 | Multi | Persistent | 6 | Loop recorder | 3, 6 | RF CF | PVI + LAPWI | Rate control | Change in LVEF | Good |
Marrouche (2018)[33] | 179/184 | Multi | Persistent 70% Paroxysmal 30% | 38 | ICD/CRT-D | 3, 6, 12, 24, 36, 48, 60 (device interrogation) | Operator discretion | PVI + Operator discretion | Rate or Rhythm control | Mortality and heart failure hospitalization | Fair |