Heart failure is a widespread disease in Germany, affecting an estimated 2.5 million people, and is one of the leading causes of death. Approximately one million heart failure patients also suffer from atrial fibrillation, a heart rhythm disorder characterized by uncontrolled atrial fibrillation and irregular, often rapid, heartbeats. Because blood clots can form in the heart, patients with atrial fibrillation have a significantly increased risk of stroke.
Atrial fibrillation can usually be effectively treated with a procedure called catheter ablation. Using a catheter advanced through the blood vessels in the groin to the left atrium, specific areas of heart tissue around the pulmonary veins are ablated, interrupting the harmful propagation of impulses.
How does ablation therapy for atrial fibrillation in heart failure patients affect the progression of heart failure? CABA-HFPEF-DZHK27" aims to answer this question. It is an international study involving 60 centers across Europe and co-funded by the German Center for Cardiovascular Research (DZHK) with 3.2 million euros. The principal investigator of the study is Abdul Shokor Parwani, MD, Head of Electrophysiology at the German Heart Center of the Charité (DHZC, Campus Virchow-Klinikum/Mittelallee).
The study abbreviation CABA-HFPEF stands for "CAtheter-Based Ablation of atrial fibrillation compared to conventional treatment in patients with Heart Failure with Preserved Ejection Fraction" because the researchers are focusing on heart failure patients with preserved (HFpEF) or only slightly reduced ejection fraction. "In this case, the strength of the heart is still largely intact, but the heart muscle has become so stiff that the ventricles cannot fill sufficiently with blood," explains Parwani.
This form of heart failure accounts for more than half of all heart failure cases. However, there are still few therapies available to improve the condition and prognosis of these patients, says the DHZC cardiologist: "We therefore want to find out whether catheter ablation of atrial fibrillation is superior to the current standard drug treatment in this group of patients, i.e. whether it improves performance and reduces the frequency of hospital admissions and mortality.
Nearly 1,550 patients across Europe will be randomized to either ablation or medical therapy with clearly defined inclusion and exclusion criteria. After intensive preparation, Detlef B. from Berlin is the first of these patients to be enrolled in the trial. The 59-year-old has both HFpEF and atrial fibrillation. Detlef B. was randomly assigned to the "ablation arm" of the study and was treated with electroporation, a new, remarkably effective yet gentle ablation procedure, which has so far only been performed in Berlin and Brandenburg at the DHZC's Department of Cardiology on the Virchow-Klinkum/Mittelallee campus. The procedure was performed without complications and Detlef B. was discharged the following day. 1549 patients in 60 clinics will now follow him.
"This was a big and important step in expanding our knowledge about the therapeutic options of catheter ablation of atrial fibrillation in heart failure patients - congratulations to Dr. Parwani and his team," said Prof. Gerhard Hindricks, MD, Chief Integration Officer at the DHZC.
Study title: CAtheter-Based Ablation of atrial fibrillation compared to conventional treatment in patients with Heart Failure with Preserved Ejection Fraction (CABA-HFPEF-DZHK27) CABA-HFPEF-DZHK27
Source: Pressemitteilung Deutsches Herzzentrum der Charité, DHZC
