Safety and efficacy of percutaneous coronary intervention combined with catheter ablation in a single procedure for patients with coronary artery disease complicated with atrial fibrillation

Abstract

Abstract Background Coronary artery disease (CAD) always co-exists with atrial fibrillation (AF). A new delivery of cardiac interventions for patients is needed during or even after the 2019 coronavirus disease (COVID-19) pandemic. This study aimed to evaluate the safety and efficacy of percutaneous coronary interventions (PCI) combined with AF catheter ablation (AFCA) in a single procedure for patients with CAD and AF. Methods From Jan 2020 to Jun 2021, 40 consecutive patients who underwent both PCI and AFCA were retrospectively enrolled for this study. All patients were followed up 1, 3, 6, and 12 months after the procedure. The primary safety outcomes included cardiac tamponade, cerebrovascular accident/stroke, transient ischemic attack (TIA), thromboembolism, myocardial infarction, vascular access site complications, and bleeding. The primary efficacy outcomes included 12-month AF recurrence and in-stent restenosis (ISR). Results Six adverse events were reported, including small hematoma at the groin access site in two cases, minor bleeding in three cases, and stroke not related to the procedure in one case. No ISR was reported. The Kaplan-Meier analysis estimated that the AF-free success rate at 12 months was 95.7% in paroxysmal atrial fibrillation (PAF) patients and 64.7% in those with persistent atrial fibrillation (PsAF). Conclusions The combination of PCI and AFCA in one procedure was feasible, safe, and efficacious in patients with CAD and AF. The combined procedure can be recommended in clinical practice, during or even after the COVID-19 era.