Accordingly, a marginally significant reduction in the composite end-point (CV mortality, stroke, hospitalization for worsening HF, and acute coronary syndrome) was also observed in patients undergoing CA compared with those treated with medical therapy in the pre-specified analysis of HF patients enroled in the ‘Early rhythm control therapy in patients with atrial fibrillation and heart failure’ (EAST-AFNET 4) trial. 9 In this trial, CA was performed on 140 of the 798 patients, and the authors point out that patients with HFpEF apparently benefit most from this strategy.
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