This 'should help eradicate the current somewhat nihilistic approach' to managing atrial fibrillation in advanced heart failure, said an expert.
One of the study's key messages"is that AF ablation is safe and effective in patients with end-stage heart failure" and"should be part of our armamentarium" for treating them, said Philipp Sommer, MD, also with Heart and Diabetes Center North-Rhine Westphalia, at a press conference preceding Sohns' presentation of CASTLE-HTx.
The trial"should, if anything, help eradicate the current somewhat nihilistic approach to atrial fibrillation management in patients with advanced heart failure," said Gustafsson, medical director ofand mechanical circulatory support, Rigshopsitalet Copenhagen University Hospital, Denmark. The trial population consisted of"patients referred to an advanced heart failure center, rather than patients with advanced heart failure," agreed Mandeep R. Mehra, MD, director of the Center for Advanced Heart Disease at Brigham and Woman's Hospital, Boston.
The trial entered 194 patients with symptomatic AF and HF of at least NYHA class 2, with impaired functional capacity by the 6-minute walk test, who had been referred to a major center in Germany for a heart-transplantation workup. With all on guideline-directed medical therapy, 97 were randomly assigned open-label to catheter ablation and 97 to continued standard care.
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