Atrial fibrillation ablation in patients with reduced left ventricular ejection fraction: does it only improve hemodynamics or does it affect the prognosis? (A systematic review)

Objective: To critically evaluate the results of studies concerning the impact of atrial fibrillation ablation on hemodynamics and prognosis in patients with heart failure with reduced left ventricular ejection fraction. Methods: We searched via keywords in the PubMed, Embase, Cochrane Library, and Web of Science databases and selected the most-cited studies containing data on the ablation treatment of patients with atrial fibrillation and heart failure with reduced left ventricular ejection fraction, including such treatment end points as left ventricular ejection fraction, mortality, etc. We analyzed the effect of ablation on changes in left ventricular ejection fraction and clinical outcomes in patients with atrial fibrillation compared with that of drug therapy. Results: We screened 4581 literature sources: of them, 48 were selected for the review. Compared with drug therapy in similar patients with atrial fibrillation and heart failure, there is a 4-fold absolute increase (P