AF and HF - Ablation and AF Management in HF Patients-AF and HF - Ablation and AF Management in HF Patients

Video Transcription

Video Summary

The session discussed atrial fibrillation (AF) management in patients with heart failure (HF), with a focus on rhythm versus rate control in HF with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Dr. Sandeep Prabhu emphasized that rhythm control is superior for patients with AF and HFrEF, as restoring sinus rhythm can improve mortality, hospitalization rates, functional capacity, and quality of life. Studies show that catheter ablation, specifically rhythm control, is beneficial and is supported by recent guidelines.<br /><br />Patient selection and ablation strategies were reviewed by Dr. Nasir Maroosh, emphasizing less lesion creation during procedures to preserve atrial function, crucial in HF management. PVI (pulmonary vein isolation) was highlighted as the recommended initial strategy, with ablation being timely and preferably within six months after diagnosis for HFrEF patients.<br /><br />Dr. Betsy Kaufman discussed withdrawing guideline-directed medical therapy (GDMT) in patients who recover ejection fraction post-ablation. The findings suggest some patients can safely reduce or eliminate medications under careful monitoring.<br /><br />Scott Brancato assessed whether AF ablation in HFpEF is ready for prime time, concluding it is, although more evidence from ongoing studies like CASEL-AF2 and CABA-HFpEF is necessary. While evidence favors ablation's role in improving outcomes, HFpEF's varying phenotypes necessitate nuanced approaches.<br /><br />Throughout, the importance of interdisciplinary collaboration, particularly involving heart failure and electrophysiology specialists, was emphasized to ensure holistic patient management.

Keywords

atrial fibrillation

heart failure

rhythm control

rate control

HFrEF

HFpEF

catheter ablation

pulmonary vein isolation

ejection fraction

interdisciplinary collaboration