TY - JOUR
T1 - Influence of time to ablation on outcomes among patients with atrial fibrillation with pre-existing heart failure
AU - Lador, Adi
AU - Maccioni, Sonia
AU - Khanna, Rahul
AU - Zhang, Dongyu
N1 - Publisher Copyright:
© 2024 Heart Rhythm Society
PY - 2024/9
Y1 - 2024/9
N2 - 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.
AB - 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.
KW - Atrial fibrillation
KW - Cardiology
KW - Catheter ablation
KW - Epidemiology
KW - Heart failure
UR - http://www.scopus.com/inward/record.url?scp=85202186873&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85202186873&partnerID=8YFLogxK
U2 - 10.1016/j.hroo.2024.07.016
DO - 10.1016/j.hroo.2024.07.016
M3 - Article
C2 - 39493909
AN - SCOPUS:85202186873
SN - 2666-5018
VL - 5
SP - 606
EP - 613
JO - Heart Rhythm O2
JF - Heart Rhythm O2
IS - 9
ER -