Mechanisms of Improved Mortality Following Ablation: Does Ablation Restore Beta-Blocker Benefit in Atrial Fibrillation/Heart Failure?

Cardiol Clin. 2019 May;37(2):177-183. doi: 10.1016/j.ccl.2019.01.011. Epub 2019 Feb 27.

Abstract

Observational trials have shown that atrial fibrillation ablation favorably impacts long-term outcomes in systolic heart failure. These outcomes have been confirmed by randomized prospective trials highlighting the favorable impact of ablation on left ventricular function and remodeling, risk of heart failure hospitalization, and mortality. Ablation along with established heart failure medications is new and supported conceptually by the value of restoring sinus rhythm, avoiding long-term antiarrhythmic drugs, and minimizing drug-drug interactions. Observational data suggest a potential long-term benefit of beta-blockers with ablation that becomes augmented as follow-up is extended from 1 to 5 years.

Keywords: Atrial fibrillation; Beta-blockers; Catheter ablation; Congestive heart failure; Mortality.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Atrial Fibrillation / mortality*
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / surgery
  • Catheter Ablation*
  • Comorbidity
  • Global Health
  • Heart Failure / mortality*
  • Heart Failure / physiopathology
  • Humans
  • Postoperative Period
  • Stroke Volume / physiology*
  • Survival Rate / trends
  • Ventricular Function, Left / physiology*

Substances

  • Adrenergic beta-Antagonists