The Promising Reality of AF Ablation in End-Stage HF

The CASTLE HTx trial presented at the European Society of Cardiology congress showed that catheter ablation of atrial fibrillation (AF) in patients with advanced heart failure resulted in significantly positive outcomes compared to medical therapy. The trial involved a highly select group of patients, and after a median follow-up of 18 months, the ablation group had a significantly lower rate of death, implantation of a left ventricular assist device, or urgent heart transplantation compared to the medical therapy group. However, some experts have raised concerns about the small sample size and the early separation of event curves, suggesting that the results may not be reproducible in larger studies.