Key result
Autoimmune disease in patients undergoing catheter ablation for atrial fibrillation was associated with a similar risk of recurrence compared to non-AD patients (HR 1.23; 95% CI 0.86-1.76; p=0.21).
Why the study?
Evidence on outcomes of catheter ablation for AF in patients with autoimmune disease is limited.
Does catheter ablation for atrial fibrillation result in similar recurrence rates in patients with autoimmune disease compared to matched non-AD patients?
Cohort (n=535)
Does catheter ablation for atrial fibrillation result in similar recurrence rates in patients with autoimmune disease compared to matched non-AD patients?
Catheter ablation for atrial fibrillation in patients with autoimmune disease yields a similar long-term risk of recurrence compared to non-AD patients, despite a higher rate of early recurrences.
Supports ablation in autoimmune disease patients; leaves open need for randomized confirmation of equivalence.
BACKGROUND: Evidence on outcomes of catheter ablation (CA) for atrial fibrillation (AF) in patients with autoimmune disease (AD) is limited. HYPOTHESIS: Patients with AD had worse outcomes after CA procedures for AF. METHODS: A retrospective analysis was performed in patients undergoing AF ablation between 2012 and 2021. The risk of recurrence after ablation was investigated in patients with AD and a 1:4 propensity score matched non-AD group. RESULTS: We identified 107 patients with AD (64 ± 10 years, female 48.6%) who were matched with 428 non-AD patients (65 ± 10 years, female 43.9%). Patients with AD exhibited more severe AF-related symptoms. During the index procedure, a higher proportion of AD patients received nonpulmonary vein trigger ablation (18.7% vs. 8.4%, p = 0.002). Over a median follow-up of 36.3 months, patients with AD experienced a similar risk of recurrence with the non-AD group (41.1% vs. 36.2%, p = 0.21, hazard ratio [HR]: 1.23, 95% confidence interval [CI]: 0.86-1.76) despite a higher incidence of early recurrences (36.4% vs. 13.5%, p = 0.001). Compared with non-AD patients, patients with connective tissue disease were at an increased risk of recurrence (46.3% vs. 36.2%, p = 0.049, HR: 1.43, 95% CI: 1.00-2.05). Multivariate Cox regression analysis showed that the duration of AF history and corticosteroid therapy were independent predictors of postablation recurrence in patients with AD. CONCLUSIONS: In patients with AD, the risk of recurrence after ablation for AF during the follow-up was comparable with non-AD patients, but a higher risk of early recurrence was observed. Further research into the impact of AD on AF treatment is warranted.
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Gao et al. (2023) conducted a cohort in Atrial fibrillation and autoimmune disease (n=535). Autoimmune disease vs. Non-autoimmune disease was evaluated on Recurrence after ablation (HR 1.23, 95% CI 0.86-1.76, p=0.21). Autoimmune disease in patients undergoing catheter ablation for atrial fibrillation was associated with a similar risk of recurrence compared to non-AD patients (HR 1.23; 95% CI 0.86-1.76; p=0.21).
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