Withdrawal of heart failure therapy after atrial fibrillation rhythm control with ejection fraction normalization: the WITHDRAW-AF trial.

ABSTRACT:

Background and aims

Atrial fibrillation-mediated cardiomyopathy (AFCM) represents an important reversible cause of left ventricular systolic dysfunction. Current clinical practice is indefinite heart failure (HF) pharmacotherapy despite left ventricular ejection fraction (LVEF) normalization. However, whether this is necessary to maintain normal LVEF, in addition to rhythm control, is uncertain.

Methods

This multi-centre, randomized trial conducted between 2021 and 2024 examined the impact of staged withdrawal of HF therapy following AF rhythm control and LVEF normalization in AFCM. Participants were randomized (1:1) to early withdrawal (Group A) or continued therapy for 6 months followed by delayed withdrawal (Group B), in a crossover design. The primary endpoint was the ra

SUBMITTER: Segan L 

PROVIDER: S-EPMC12777703 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature