Heart Failure Medication Withdrawal in Patients With Improved Cardiac Function After Atrial Fibrillation Ablation

Is discontinuation of guideline-directed medical therapy (GDMT) after catheter ablation feasible and safe in patients with atrial fibrillation (AF) with improved cardiac function?In this randomized clinical trial of 50 patients with AF and heart failure (HF) with improved ejection fraction (suspected with AF-mediated cardiomyopathy), phased GDMT withdrawal in those with normalized left ventricular ejection fraction and sinus rhythm resulted in HF deterioration in 3 of 23 patients (13%) compared with none in the continuation group. This was not a statistically significant difference.Although this study did not find significantly more HF deterioration in patients who discontinued GDMT vs those who continued, further studies are needed to determine whether GDMT can be safely discontinued in this population.

Corresponding Authors: Caihua Sang, MD, Department of Cardiology (sch9613070@sina.com), and Hui Wang, MD, Department of Radiology (hugeren@126.com), Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd, Chaoyang District, Beijing 100029, China.

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