Key result
Early ablation linked to ~32% lower arrhythmia recurrence vs. late ablation in persistent AF.
Why the study?
The relationship between catheter ablation timing and post-ablation outcomes in older patients with persistent AF remains uncertain.
Does early catheter ablation (diagnosis-to-ablation time ≤12 months) reduce atrial arrhythmia recurrence and adverse cardiovascular outcomes in older patients with persistent atrial fibrillation compared to delayed ablation?
Cohort (n=587)
Yes
Does early catheter ablation (diagnosis-to-ablation time ≤12 months) reduce atrial arrhythmia recurrence and adverse cardiovascular outcomes in older patients with persistent atrial fibrillation compared to delayed ablation?
Hazard Ratio: 0.68 (95% CI 0.52–0.91)
Absolute Event Rate: 67.9% vs 59.1%
p-value: p=0.005
In older patients with persistent AF, performing catheter ablation within 12 months of diagnosis is associated with significantly lower arrhythmia recurrence and fewer cardiovascular hospitalizations compared to delaying the procedure.
Early ablation was associated with lower recurrence in older persistent AF; extends observational timing data but leaves causal effects open.
BACKGROUND: The relationship between the timing of catheter ablation and post-ablation outcomes in older patients with persistent atrial fibrillation (AF) remains uncertain. OBJECTIVES: This study aimed to investigate whether diagnosis-to-ablation time (DAT) influences post-ablation outcomes in older patients with persistent AF. METHODS: From January 2020 to December 2022, 587 patients were stratified into 2 groups: the early ablation group (DAT ≤12 months, n = 332) and the late ablation group (DAT >12 months, n = 255) based on DAT. The study outcomes included freedom from atrial arrhythmia (AA) recurrence and adverse cardiovascular outcomes (death, cardiovascular hospitalization, ischemic stroke, and a composite outcome comprising all 3 outcomes). RESULTS: The final analysis included 560 patients after 27 patients were lost to follow-up. After 24 months follow-up, 67.9% (216/318 patients) with the early ablation group were freedom from AA recurrence vs 59.1% (143/242 patients) in the late ablation group (HR: 0.68; 95% CI: 0.52-0.91; P = 0.005). Moreover, the late ablation group showed higher risks of the composite outcome (HR: 1.70; 95% CI: 1.23-2.34; P = 0.001) and cardiovascular hospitalization (HR: 1.57; 95% CI: 1.10-2.26; P = 0.011) compared with the early ablation group at 24-month follow-up. Ischemic stroke (HR: 1.87; 95% CI: 0.83-4.19; P = 0.126) and death (HR: 2.20; 95% CI: 0.54-8.93; P = 0.267) did not differ significantly between the 2 groups. CONCLUSIONS: In older patients with persistent AF, a DAT ≤12 months was associated with lower AA recurrence and lower risk of adverse cardiovascular outcomes, suggesting that early catheter ablation may improve clinical outcomes in this population.
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Wang et al. (2025) conducted a cohort in Persistent Atrial Fibrillation (n=587). Early catheter ablation (diagnosis-to-ablation time ≤12 months) vs. Late catheter ablation (diagnosis-to-ablation time >12 months) was evaluated on Freedom from atrial arrhythmia (AA) recurrence (HR 0.68, 95% CI 0.52-0.91, p=0.005). Early catheter ablation (diagnosis-to-ablation time ≤12 months) in older adults with persistent atrial fibrillation significantly increased freedom from atrial arrhythmia recurrence compared to late ablation (67.9% vs 59.1%, HR 0.68).
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