Role of atrial fibrillation ablation in the treatment of heart failure patients: focus on CASTLE-AF trial
Szegedi Nándor, Németh Tamás, Liptai Csilla, Nagy Anikó Ilona, Zima Endre, Molnár Levente, Tahin Tamás, Széplaki Gábor, Merkely Béla, Gellér László
Semmelweis Egyetem, Városmajori Szív- és Érgyógyászati Klinika, Budapest
Atrial fibrillation (AF) is the most frequent sustained cardiac arrhythmia. Therapy of AF should be based on treatment of underlying cardiovascular diseases, anticoagulation, rate and/or rhythm control. Catheter ablation of AF is the most successful method for rhythm control however no randomized trial proved that it would improve patients’ survival. „CASTLE-AF” trial was published recently in the New England Journal of Medicine. This prospective randomized study found that catheter ablation of atrial fibrillation improved the primary endpoint, moreover it also provided mortality benefit compared to the medical therapy in heart failure patients. It remains a question whether catheter ablation of atrial fibrillation will become a basic therapy of heart failure patients. Further ongoing trials are under investigation to answer this question.