Catheter ablation significantly reduced median atrial tachyarrhythmia burden from 15% to 0% over a median follow-up of 40.9 months (p<0.001), accompanied by sustained quality of life improvements.
Cohort (n=165)
No
Does first-time catheter ablation reduce atrial tachyarrhythmia burden in patients with paroxysmal or persistent atrial fibrillation?
Catheter ablation produces a durable and substantial reduction in atrial tachyarrhythmia burden over 4 years, accompanied by sustained improvements in quality of life.
Absolute Event Rate: 0% vs 15%
p-value: p=<0.001
BACKGROUND Atrial fibrillation (AF) markedly impairs quality of life and increases healthcare burden. Long-term outcomes of catheter ablation (CA) using continuous rhythm monitoring remain under-characterized. OBJECTIVE To assess atrial tachyarrhythmia burden (ATaB) using implantable cardiac monitors (ICMs) before and up to 4 years after CA, and to examine the association between ATaB reduction and quality of life (QoL). In an exploratory proof-of-concept analysis we evaluated whether simulated intermittent monitoring (Burden-by-Sampling, BBS) can approximate ICM-derived ATaB. METHODS In this single-centre, prospective cohort, 165 patients with paroxysmal or persistent AF underwent first-time CA after pre-ablation ICM insertion. ATaB (percentage time in AF/atrial tachycardia) was continuously recorded for up to 4 years. Annual QoL assessments used the SF-36 and an AF-specific symptom questionnaire. Retrospective BBS simulation sampled ICM data at varying frequencies to explore intermittent monitoring performance. RESULTS Median follow-up was 40.9 months. Median ATaB declined from 15% 0-100 to 0% 0-22.5 (p90% of patients achieved ≥75% reduction. QoL improved significantly at 1 year and remained stable, although physical SF-36 scores were not consistently significant beyond 1 year. BBS performance improved with increased sampling frequency but remains exploratory. CONCLUSION CA produces a durable, substantial reduction in ATaB over 4 years, with sustained QoL benefit. These findings challenge binary definitions of ablation success and support burden-based, patient-centred endpoints. Exploratory BBS simulations suggest potential for intermittent monitoring but require prospective validation.
Almorad et al. (Thu,) conducted a cohort in Paroxysmal or persistent atrial fibrillation (n=165). Catheter ablation vs. Pre-ablation baseline was evaluated on Atrial tachyarrhythmia burden (ATaB) (p=<0.001). Catheter ablation significantly reduced median atrial tachyarrhythmia burden from 15% to 0% over a median follow-up of 40.9 months (p<0.001), accompanied by sustained quality of life improvements.