Key result
COVID-19 era linked to ~44% lower late AF recurrence after ablation in paroxysmal AF.
Why the study?
Changes in outcomes of atrial fibrillation catheter ablation during the COVID-19 pandemic and the impact of government social distancing measures were not well understood.
Does undergoing de novo atrial fibrillation catheter ablation during the COVID-19 era reduce late recurrence of atrial arrhythmias in patients with atrial fibrillation compared to the pre-COVID-19 era?
Cohort (n=1,054)
Does undergoing de novo atrial fibrillation catheter ablation during the COVID-19 era reduce late recurrence of atrial arrhythmias in patients with atrial fibrillation compared to the pre-COVID-19 era?
Hazard Ratio: 0.56 (95% CI 0.35–0.9)
Absolute Event Rate: 9.4% vs 17%
p-value: p=0.004
The COVID-19 pandemic and associated public restrictions were associated with a reduced risk of late recurrence after catheter ablation in patients with paroxysmal atrial fibrillation, but not in those with persistent atrial fibrillation.
Associated with lower paroxysmal AF recurrence after ablation in COVID-19 era; leaves open causal role of pandemic factors in this cohort.
Background Here we aimed to analyze changes in the outcomes of atrial fibrillation (AF) catheter ablation (AFCA) during the coronavirus disease 2019 (COVID-19) pandemic and examine the relationship between rhythm outcomes and the stringency of government social distancing measures. Methods We included 453 patients who underwent de novo AFCA between May 2018 and October 2019 (pre-COVID-19 era) and 601 between November 2019 and April 2021 (COVID-19 era). The primary outcome was late recurrence, defined as any episode of AF or atrial tachycardia documented after a 3-month blanking period. A multivariable Cox regression analysis was performed to estimate the relative hazards of AF recurrence in the two eras. Results In the study population (24.3% women; median age, 60 years), 660 (62.6%) patients had paroxysmal AF. Among those with paroxysmal AF, the late recurrence rate was significantly lower in the COVID-19 era than in the pre-COVID-19 era [9.4% vs. 17.0%, respectively, log-rank P = 0.004; adjusted hazard ratio (HR) 0.56, 95% confidence interval (CI) 0.35–0.90] during a median follow-up of 11 months. In patients with persistent AF, the late recurrence rate did not significantly differ between the pre-COVID-19 and COVID-19 era groups (18.9% vs. 21.5%, respectively; log-rank P = 0.523; adjusted HR 0.84, 95% CI 0.47–1.53) during the median follow-up of 11 months. Conclusion A decrease in AF recurrence after catheter ablation was observed in patients with paroxysmal AF during the COVID-19 outbreak, whereas no change was observed in those with persistent AF.
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Kim et al. (2022) conducted a cohort in Atrial fibrillation (n=1,054). COVID-19 era vs. Pre-COVID-19 era was evaluated on Late recurrence (any episode of AF or atrial tachycardia documented after a 3-month blanking period) in paroxysmal AF (HR 0.56, 95% CI 0.35-0.90, p=0.004). The COVID-19 era was associated with a lower rate of late recurrence after catheter ablation in patients with paroxysmal AF (HR 0.56; 95% CI 0.35-0.90) but no change in those with persistent AF.
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