For patients diagnosed with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF), whether catheter ablation offers advantages over medical therapy remains a common clinical question. In Journal of Arrhythmia, a meta-analysis assessed outcomes associated with catheter ablation compared with medical therapy in patients with AF and HFpEF. The analysis included 12 studies, encompassing a total of 43,584 individuals.

Catheter ablation was associated with a significantly lower risk of the primary composite endpoint, with a pooled hazard ratio (HR) of 0.53 (95% confidence interval [CI], 0.41-0.68; p < 0.01). Hospitalizations due to heart failure were also reduced (HR, 0.62; 95% CI, 0.48-0.81; p < 0.01), along with a lower rate of all-cause mortality (HR, 0.64; 95% CI, 0.45-0.91; p < 0.01). The analysis demonstrated a significant association between catheter ablation and reduced stroke risk (HR, 0.66; 95% CI, 0.60-0.72; p < 0.01). A trend toward reduced AF recurrence was observed, although this outcome did not reach statistical significance.

These findings show that catheter ablation was associated with improved clinical outcomes compared with medical therapy in patients with AF and HFpEF.