Atrial Fibrillation and Heart Failure: to build a CASTLE you need a solid foundation

The authors claim that their score identifies heart failure (HF) patients who benefit the most from atrial fibrillation (AF) ablation. However, the crude hazard ratio (HR) for the primary endpoint was 0.32 in favour of ablation in the “high-risk group” and 0.41 in the “low-risk group”. Thus, AF ablation appears to perform equally well in both groups, but the higher number of events makes this different statistically significant only in the high-risk group. More than identifying patients who benefit from the ablation, the score seems to identify patients who will have worse outcomes, irrespective of the treatment strategy.
Source: Heart Rhythm - Category: Cardiology Authors: Source Type: research