Key result
Post-ablation AF recurrence links to age and AF type, with lowest rates in younger paroxysmal patients.
Why the study?
Outcomes after catheter ablation could differ among patients with AF depending on age and AF type, but differences in outcome predictors across these categories were not well defined.
Cohort (n=396)
No
Predictors of atrial fibrillation recurrence after catheter ablation vary significantly by age and AF type, with diabetes and female sex predicting recurrence in younger patients with paroxysmal AF, while RAS inhibitors may prevent recurrence in younger patients with persistent AF.
Stratification by age and AF type may guide post-ablation monitoring; leaves open whether tailored strategies improve outcomes in prospective trials.
BACKGROUND: The outcome of catheter ablation could probably differ among patients with atrial fibrillation (AF), depending on age and AF type. We aimed to investigate the difference in predictors of outcome after catheter ablation for AF among the patient categories divided by age and AF type. METHODS AND RESULTS: A total of 396 patients with AF (mean age 65.69 ± 11.05 years, 111 women [28.0%]) who underwent catheter ablation from January 2018 to December 2019 were retrospectively analyzed. We divided the patients into four categories: patients with paroxysmal AF (PAF) or persistent AF (PeAF) who were 75 years or younger (≤75 years) or older than 75 years (>75 years). Kaplan-Meier survival analysis demonstrated that patients with PAF aged ≤75 years had the lowest AF recurrence among the four groups (log-rank test, p = .0103). In the patients with PAF aged ≤75 years (N = 186, 46.7%), significant factors associated with recurrence were female sex (p = .008) and diabetes (p = .042). In the patients with PeAF aged ≤75 years (N = 142, 35.9%), the only significant factor associated with no recurrence was medication with a renin-angiotensin system inhibitor (p = .044). In the patients with PAF aged >75 years (N = 53, 14.4%), diabetes was significantly associated with AF recurrence (p = .021). No significant parameters were found in the patients with PeAF aged >75 years (N = 15, 4.1%). CONCLUSIONS: Our findings indicate that the risk factors for AF recurrence after catheter ablation differed by age and AF type.
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Uemura et al. (2022) conducted a cohort in Atrial Fibrillation (n=396). Age and AF type categories vs. Between groups was evaluated on Atrial fibrillation recurrence (p=0.0103). Atrial fibrillation recurrence after catheter ablation differed significantly by age and AF type (p=0.0103), with patients aged ≤75 years with paroxysmal AF having the lowest recurrence rate.
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