Diagnosis-to-ablation time > 1 year was independently associated with a higher risk of atrial fibrillation recurrence compared to early intervention (HR 4.2; 95% CI 1.5-11.9; P=0.007).
Cohort
Yes
Does a diagnosis-to-ablation time ≤ 1 year reduce atrial fibrillation recurrence in patients undergoing their first AF ablation?
A diagnosis-to-ablation time of greater than 1 year is a strong, modifiable independent predictor of AF recurrence after first ablation, suggesting that early intervention improves outcomes.
Effect estimate: HR 4.2 (95% CI 1.5-11.9)
p-value: p=0.007
INTRODUCTION: Recurrences after atrial fibrillation (AF) ablation are still common. Among the reported clinical and imaging predictors of recurrences, diagnosis-to-ablation time (DAT) has been defined as a predictor of ablation outcome in single-center studies. We aimed to validate DAT in a multicenter real-life cohort. METHODS: This was a multicenter study including consecutive patients undergoing first paroxysmal and persistent AF ablation with radiofrequency or cryoballoon catheters during 2013. Cox proportional hazard regression models were performed to identify predictors of recurrence. RESULTS: -VASc ≤ 1). Most patients had paroxysmal AF (67%) and underwent radiofrequency ablation (68%) with a median DAT of 51 (43) months. Patients with DAT ≤ 1 year (16.6%) were less likely to have repeat procedures (4% vs 18%; P = .017). The adjusted proportional hazards Cox model identified hypertension (P = .005), heart failure (P = .011), nonparoxysmal AF (P = .038), DAT > 1 year (P = .007), and LA diameter (P = .026) as independent predictors for AF recurrence. DAT > 1 year was the only modifiable factor independently associated with recurrence (HR 4.2 95% CI, 1.5-11.9) CONCLUSION: Diagnosis-to-ablation time is a modifiable factor independently associated with recurrent arrhythmia and repeat ablation after first AF ablation. An early intervention strategy during the first year from AF diagnosis might improve outcomes.
Bisbal et al. (Wed,) conducted a cohort in Atrial fibrillation. Diagnosis-to-ablation time > 1 year vs. Diagnosis-to-ablation time ≤ 1 year was evaluated on Atrial fibrillation recurrence (HR 4.2, 95% CI 1.5-11.9, p=0.007). Diagnosis-to-ablation time > 1 year was independently associated with a higher risk of atrial fibrillation recurrence compared to early intervention (HR 4.2; 95% CI 1.5-11.9; P=0.007).