Lower Recurrence Rates of Atrial Fibrillation and MACE Events After Early Compared to Late Ablation: A Danish Nationwide Register Study
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Lower Recurrence Rates of Atrial Fibrillation and MACE Events After Early Compared to Late Ablation : A Danish Nationwide Register Study. / Tønnesen, Jacob; Ruwald, Martin H.; Pallisgaard, Jannik; Rasmussen, Peter Vibe; Johannessen, Arne; Hansen, Jim; Worck, Rene H.; Zörner, Christopher R.; Riis-Vestergaard, Lise; Middelfart, Charlotte; Sørensen, Samuel K.; Sattler, Stefan; Gislason, Gunnar; Hansen, Morten Lock.
I: Journal of the American Heart Association, Bind 13, Nr. 7, e032722, 2024.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Lower Recurrence Rates of Atrial Fibrillation and MACE Events After Early Compared to Late Ablation
T2 - A Danish Nationwide Register Study
AU - Tønnesen, Jacob
AU - Ruwald, Martin H.
AU - Pallisgaard, Jannik
AU - Rasmussen, Peter Vibe
AU - Johannessen, Arne
AU - Hansen, Jim
AU - Worck, Rene H.
AU - Zörner, Christopher R.
AU - Riis-Vestergaard, Lise
AU - Middelfart, Charlotte
AU - Sørensen, Samuel K.
AU - Sattler, Stefan
AU - Gislason, Gunnar
AU - Hansen, Morten Lock
PY - 2024
Y1 - 2024
N2 - BACKGROUND: Guidelines recommend prioritizing treatment with antiarrhythmic drugs before referral of patients with atrial fibrillation to ablation, delaying a potential subsequent ablation. However, delaying ablation may affect ablation outcomes. We sought to investigate the impact of duration from diagnosis to ablation on the risk of atrial fibrillation recurrence and adverse events. METHODS AND RESULTS: Using Danish nationwide registries, all patients with first-time ablation for atrial fibrillation were identified and included from 2010 to 2018. Patients were divided into 4 groups by diagnosis-to-ablation time: <1.0 year (early ablation), 1.0 to 1.9 years, 2.0 to 2.9 years, and >2.9 years (late ablation). The primary end point was atrial fibrillation recurrence after the 90-day blanking period, defined by admission for atrial fibrillation, cardioversions, use of antiarrhythmic drugs, or repeat atrial fibrillation ablations. The secondary end point was a composite end point of heart failure, ischemic stroke, or death, and each event individually. The study cohort consisted of 7705 patients. The 5-year cumulative incidence of atrial fibrillation recurrence in the 4 groups was 42.9%, 54.8%, 55.9%, and 58.4%, respectively. Hazard ratios were 1.20 (95% CI, 1.07-1.35), 1.29 (95% CI, 1.13-1.47), and 1.40 (95% CI, 1.28-1.53), respectively, with the early ablation group as reference. The hazard ratio for the combined secondary end point was 1.22 (95% CI, 1.04-1.44) in the late ablation group compared with the early ablation group. CONCLUSIONS: In patients undergoing ablation for atrial fibrillation, early ablation was associated with a significantly lower risk of atrial fibrillation recurrence. Furthermore, the associated risk of heart failure, ischemic stroke, or death was significantly lower in early-compared with late-ablation patients.
AB - BACKGROUND: Guidelines recommend prioritizing treatment with antiarrhythmic drugs before referral of patients with atrial fibrillation to ablation, delaying a potential subsequent ablation. However, delaying ablation may affect ablation outcomes. We sought to investigate the impact of duration from diagnosis to ablation on the risk of atrial fibrillation recurrence and adverse events. METHODS AND RESULTS: Using Danish nationwide registries, all patients with first-time ablation for atrial fibrillation were identified and included from 2010 to 2018. Patients were divided into 4 groups by diagnosis-to-ablation time: <1.0 year (early ablation), 1.0 to 1.9 years, 2.0 to 2.9 years, and >2.9 years (late ablation). The primary end point was atrial fibrillation recurrence after the 90-day blanking period, defined by admission for atrial fibrillation, cardioversions, use of antiarrhythmic drugs, or repeat atrial fibrillation ablations. The secondary end point was a composite end point of heart failure, ischemic stroke, or death, and each event individually. The study cohort consisted of 7705 patients. The 5-year cumulative incidence of atrial fibrillation recurrence in the 4 groups was 42.9%, 54.8%, 55.9%, and 58.4%, respectively. Hazard ratios were 1.20 (95% CI, 1.07-1.35), 1.29 (95% CI, 1.13-1.47), and 1.40 (95% CI, 1.28-1.53), respectively, with the early ablation group as reference. The hazard ratio for the combined secondary end point was 1.22 (95% CI, 1.04-1.44) in the late ablation group compared with the early ablation group. CONCLUSIONS: In patients undergoing ablation for atrial fibrillation, early ablation was associated with a significantly lower risk of atrial fibrillation recurrence. Furthermore, the associated risk of heart failure, ischemic stroke, or death was significantly lower in early-compared with late-ablation patients.
KW - ablation
KW - atrial fibrillation
KW - diagnosis‐to‐ablation time
KW - recurrence of atrial fibrillation
U2 - 10.1161/JAHA.123.032722
DO - 10.1161/JAHA.123.032722
M3 - Journal article
C2 - 38533962
AN - SCOPUS:85189751718
VL - 13
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
SN - 2047-9980
IS - 7
M1 - e032722
ER -
ID: 388946525