Influence of time to ablation on outcomes among patients with atrial fibrillation with pre-existing heart failure

Adi Lador, Sonia Maccioni, Rahul Khanna, Dongyu Zhang

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Atrial fibrillation (AF) and heart failure (HF) are cardiac disorders that often coexist.

OBJECTIVE: This study aimed to investigate how time to ablation could influence the outcomes of AF patients with pre-existing HF.

METHODS: Using the 2013 to 2022 Optum Clinformatics database, AF patients with pre-existing HF were classified into 2 groups: early ablation (ablation within 6 months of AF diagnosis) and late ablation (ablation in the 6- to 24-month period after AF diagnosis). Outcomes including AF-related hospitalization, electrical cardioversion, repeat ablation, antiarrhythmic drug (AAD) use, and AF recurrence (a composite outcome of the aforementioned events) were assessed in the postblanking 24-month period. Inverse probability of treatment weighted Poisson regression estimated risk ratio (RR) and 95% confidence interval (CI) for each outcome.

RESULTS: Overall, 601 patients were identified (early ablation: 347; late ablation: 254). In 24 months, the weighted data suggested that patients in the early ablation cohort had significantly lower rate of composite outcome (49.32% vs 61.39%, P = .01), repeat ablation (8.56% vs 17.35%, P < .01), and AAD use (35.95% vs 47.92%, P = .01). Early ablation was associated with a 20%, 51%, and 25% lower risk of composite outcome (RR 0.80, 95% CI 0.69-0.94), repeat ablation (RR 0.49, 95% CI 0.31-0.79), and AAD use (RR 0.75, 95% CI 0.61-0.92), respectively. No significant difference in AF-related hospitalization and electrical cardioversion were observed.

CONCLUSION: AF patients with pre-existing HF undergoing ablation within 6 months of AF diagnosis have a lower risk of AF recurrence than those undergoing late ablation, which was evidenced by a lower rate of repeat ablation and AAD use.

Original languageEnglish (US)
Pages (from-to)606-613
Number of pages8
JournalHeart Rhythm O2
Volume5
Issue number9
DOIs
StatePublished - Sep 2024

Keywords

  • Atrial fibrillation
  • Cardiology
  • Catheter ablation
  • Epidemiology
  • Heart failure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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