Prognostic impact of catheter ablation in patients with asymptomatic atrial fibrillation

Author:

Kawaji Tetsuma,Shizuta SatoshiORCID,Tanaka Munekazu,Nishiwaki Shushi,Aizawa Takanori,Yamagami Shintaro,Komasa Akihiro,Yoshizawa Takashi,Kato Masashi,Yokomatsu TakafumiORCID,Miki Shinji,Ono Koh,Kimura Takeshi

Abstract

Background Catheter ablation for asymptomatic atrial fibrillation (AF) remains controversial. The aim of the present study was to explore the prognostic impact of catheter ablation in asymptomatic AF patients. Methods We performed a post-hoc analysis of 537 risk-matched pairs of AF patients receiving first-time catheter ablation or conservative management. The primary outcome measure was a composite of cardiovascular death, heart failure (HF) hospitalization, ischemic stroke, or major bleeding. The study patients were divided into asymptomatic and symptomatic patients, and were further divided according to the presence or absence of previous AF-related complications (ischemic stroke or HF hospitalization). Results Most baseline characteristics were well balanced between the catheter ablation versus conservative management groups. The median follow-up period was 5.3 years. Catheter ablation as compared to conservative management was associated with significantly lower incidence of the primary outcome measure in the asymptomatic AF patients (14.7% versus 25.4% at 8-year, log-rank P = 0.008). However, the advantage of catheter ablation was significant only in the high-risk subset of patients with the previous AF-related complications (19.2% versus 55.6% at 8-year, log-rank P = 0.006), but not in those without (13.9% and 17.3%, P = 0.08). On the other hand, among the symptomatic AF patients, catheter ablation was associated with significantly lower incidence of the primary outcome measure regardless of the previous AF-related complications. Conclusions In the post-hoc analysis of the matched AF cohort, catheter ablation as compared with conservative management was associated with better long-term clinical outcomes among asymptomatic AF patients only when the previous AF-related complications were present.

Publisher

Public Library of Science (PLoS)

Subject

Multidisciplinary

Reference14 articles.

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Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Assessment and management of asymptomatic atrial fibrillation;Heart;2023-07-28

2. Asymptomatisches Vorhofflimmern;Herzschrittmachertherapie + Elektrophysiologie;2023-03-13

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