Impact of Catheter Ablation in Patients with Atrial Flutter and Concurrent Heart Failure.

Abstract Background No studies assessed impact of AFL ablation on outcomes in patients with AFL and concurrent HF. Objectives To assess the effect of atrial flutter (AFL) ablation on mortality and heart failure (HF) readmissions in patients with AFL and HF. Methods This retrospective cohort study identified 15,952 patients with AFL and HF from the Nationwide Readmissions Database from 2016-2017. The primary outcome was a composite of all-cause mortality and/or HF readmission at one year. Secondary outcomes included HF readmission, all-cause mortality, and atrial fibrillation (AF) readmission at one year. Propensity score match (1:2) algorithm was used to adjust for confounders. Cox-proportional hazard regression was used to generate hazard ratios. Results Of the 15,952 patients, 9,889 had heart failure with reduced ejection fraction (HFrEF) and 6,063 had heart failure with preserved ejection fraction (HFpEF). In the matched HFrEF cohort (n=5,421), the primary outcome was significantly lower in patients undergoing ablation (HR 0.72, 95% CI 0.61-0.85, p Conclusions In patients with AFL and HFrEF, AFL ablation was associated with lower mortality and HF readmissions at 1 year. Patients with AFL and HFpEF did not show a similar significant reduction in the primary outcome.