Catheter ablation vs rate control in atrial fibrillation with left ventricular systolic dysfunction and fibrosis: the CAMERA-MRI II trial
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Authors
Segan L.
Kistler P.M.
Nanayakkara S.
Taylor A.
Kaye D.M.
Hare J.L.
Costello B.
Patel H.
Chieng D.
Crowley R.
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Issue Date
2025
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Article
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Abstract
Catheter ablation (CA) for atrial fibrillation (AF) and left ventricular systolic dysfunction (LVSD) is associated with left ventricular ejection fraction (LVEF) improvement, fewer heart failure (HF) hospitalizations, and improved survival and is a class I recommendation as first-line rhythm control for AF-mediated cardiomyopathy. Nonetheless, it remains unclear to what extent pre-existing structural heart disease can impede LV recovery following sinus rhythm (SR) restoration. The CAMERA-MRI I study demonstrated a diminished, albeit significant improvement in LVEF in non-ischaemic CM with fibrosis, yet CASTLE-HTx study demonstrated significant clinical benefits in patients with end-stage HF with presumed high fibrosis burdens. CAMERA-MRI II was designed to prospectively explore the impact of LV fibrosis on CA outcomes in patients with AF and LVSD compared with medical therapy.
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Journal
European heart journal
Volume
46
Issue
47