Catheter ablation within 1 year of atrial fibrillation diagnosis was associated with significantly reduced AF recurrence and major adverse clinical outcomes at 3 and 5 years (P<.001).
Cohort (n=16,806)
Yes
Does early catheter ablation (diagnosis-to-ablation time <1 year) reduce AF recurrence and adverse clinical outcomes in adults with atrial fibrillation compared to delayed ablation (≥1 year)?
Performing catheter ablation within one year of an atrial fibrillation diagnosis is associated with lower rates of AF recurrence and major adverse clinical outcomes at 5 years compared to delayed ablation.
p-value: p=<.001
Background: Updated guidelines recognize catheter ablation as a first-line therapy for symptomatic atrial fibrillation (AF). The optimal timing of catheter ablation following AF diagnosis remains uncertain. Objective: This study assessed the impact of diagnosis-to-ablation time (DAT) <1 year vs DAT ≥1 year on AF recurrence and adverse clinical outcomes. Methods: We queried the TriNetX Research Network for patients ≥18 years of age with a diagnosis of AF who underwent ablation between January 1, 2010, and June 30, 2019. Patients were stratified into cohorts based on DAT <1 year vs ≥1 year and matched using 1:1 propensity scores, resulting in 8403 patients in each cohort. The primary outcome was AF recurrence, defined as a composite of cardioversion, antiarrhythmic use, or re-ablation at 3 and 5 years, after a 3-month blanking period. Secondary outcomes included a composite of heart failure exacerbation, ischemic stroke, all-cause hospitalization, and mortality, along with individual components. Results: < .001). At 3 years, all secondary outcomes were significantly reduced in the DAT <1 year group, except for incident cerebrovascular accident and mortality. At 5 years, all secondary outcomes were significantly reduced in the DAT <1 year group. Conclusion: Catheter ablation within 1 year of AF diagnosis is associated with reduced AF recurrence and major adverse clinical outcomes. These findings support early referral for catheter ablation.
Heath et al. (Sat,) conducted a cohort in Atrial fibrillation (n=16,806). Early catheter ablation (diagnosis-to-ablation time <1 year) vs. Delayed catheter ablation (diagnosis-to-ablation time ≥1 year) was evaluated on AF recurrence (composite of cardioversion, antiarrhythmic use, or re-ablation at 3 and 5 years) (p=<.001). Catheter ablation within 1 year of atrial fibrillation diagnosis was associated with significantly reduced AF recurrence and major adverse clinical outcomes at 3 and 5 years (P<.001).