Diagnosis-to-ablation time in atrial fibrillation: A modifiable factor relevant to clinical outcome.
Felipe BisbalFrancisco AlarcónAngel Ferrero-De-Loma-OsorioJuan Jose González-FerrerConcepción Alonso-MartínMarta PachónErmengol VallésPilar Cabanas-GrandíoManuel SanchezEva BenitoAxel SarriasRicardo Ruiz-GranellJulián Pérez-VillacastínXavier ViñolasMiguel Ángel AriasJulio Martí-AlmorEnrique García-CampoIgnacio Fernández-LozanoRoger VilluendasLluis MontPublished in: Journal of cardiovascular electrophysiology (2019)
In total, 309 patients were included across nine centers (71% men, 57 ± 10 years old, 46% with hypertension, and 66% with CHA2 DS2 -VASc ≤ 1). Most patients had paroxysmal AF (67%) and underwent radiofrequency ablation (68%) with a median DAT of 51 (43) months. Patients with DAT ≤ 1 year (16.6%) were less likely to have repeat procedures (4% vs 18%; P = .017). The adjusted proportional hazards Cox model identified hypertension (P = .005), heart failure (P = .011), nonparoxysmal AF (P = .038), DAT > 1 year (P = .007), and LA diameter (P = .026) as independent predictors for AF recurrence. DAT > 1 year was the only modifiable factor independently associated with recurrence (HR 4.2 [95% CI, 1.5-11.9]) CONCLUSION: Diagnosis-to-ablation time is a modifiable factor independently associated with recurrent arrhythmia and repeat ablation after first AF ablation. An early intervention strategy during the first year from AF diagnosis might improve outcomes.
Keyphrases
- atrial fibrillation
- catheter ablation
- radiofrequency ablation
- heart failure
- left atrial
- left atrial appendage
- oral anticoagulants
- newly diagnosed
- blood pressure
- end stage renal disease
- ejection fraction
- prognostic factors
- randomized controlled trial
- direct oral anticoagulants
- percutaneous coronary intervention
- adipose tissue
- left ventricular
- coronary artery disease
- acute coronary syndrome
- optic nerve
- patient reported