Abstract 12632: The Effect of Rhythm vs. Rate Control for Atrial Fibrillation in All-Cause Mortality in Patients With Heart Failure With Preserved Ejection Fraction: A Systematic Review and Meta-Analysis

Introduction: This meta-analysis assessed the effect of rhythm control (ablation and/or antiarrhythmic medications) vs rate control for atrial fibrillation in patients with heart failure with preserved ejection fraction. Hypothesis: Rhythm control with ablation and/or antiarrhythmic medications for atrial fibrillation management may be associated with improved mortality in patients with heart failure with preserved ejection fraction. Methods: We searched the databases for studies reporting the effect of rhythm control vs rate control on mortality in patients with heart failure with preserved ejection fraction including Ovid MEDLINE, EMBASE, Scopus, Web of Science, Google Scholar, and EBSCO CINAHL. The search was not restricted to time or publication status. Outcomes included rates of long-term mortality (1 year or longer). Results: A total of 1210 studies have resulted from the literature search. A total of 9 studies and 18,011 patients were included; 56.2% men, with a mean age of 71.6 years were included in our systematic review and meta-analysis. Our analysis suggested rhythm control for atrial fibrillation was associated with lower risk all-cause mortality (1 year); (odds ratio 0.73, 95% confidence interval 0.541-0.984; P 0.03). The risk of bias is mild to moderate. Conclusions: Our results suggest that rhythm control for atrial fibrillation in patients with heart failure preserved ejection fraction was associated with lower risk all-cause long-term mortality >1 year.