Withdrawing guideline-directed medical therapy after left ventricular ejection fraction recovery following atrial fibrillation ablation: a multicentre cohort study
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Authors
Al-Aidarous, Sayed
Rajappan, Saffron
Ahluwalia, Nikhil
Uy, Christopher P.
Abdelgawad, Hatem
Vidal Horrach, Caterina
Kouadria, Sofiane
Hua, Zhen
Sandhar, Gurkiran
Cooke, Theo
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Issue Date
2025
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Article
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Abstract
BACKGROUND: Atrial fibrillation (AF)-induced cardiomyopathy (AIC) is characterised by reversible left ventricular (LV) dysfunction after restoration of sinus rhythm (SR). The need for continued guideline-directed medical therapy (GDMT) for heart failure after LV ejection fraction (LVEF) recovery in AIC after catheter ablation (CA) is unclear. METHODS: This multicentre cohort study across 12 UK centres included adults undergoing index AF ablation (June 2019-June 2024) with LVEF 0.8). SR was maintained in 82.0% vs 92.1% of patients; p=0.17. CONCLUSIONS: Selective GDMT withdrawal after sustained LVEF recovery and rhythm control did not compromise LV systolic function, remodelling or rhythm maintenance. This supports the study of personalised de-escalation strategies in AIC in prospective trials.
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Open heart
Volume
12
Issue
10