Introduction: The impact of catheter ablation for atrial fibrillation
(AF) on cardiovascular events and mortality is controversial. We
investigated the impact of sinus rhythm maintenance on major adverse
cardiac and cerebrovascular events after AF ablation from a Japanese
multicenter cohort of AF ablation. Methods and Results: We investigated
2737 consecutive patients (25.6% female, mean age 63.4 ± 10.3 years)
who underwent a first catheter ablation for AF from the Atrial
Fibrillation registry to Follow the long-teRm Outcomes and use of
aNTIcoagulants aftER Ablation (AF Frontier Ablation Registry). The
primary endpoint was a composite of stroke, transient ischemic attack,
cardiovascular events, and all-cause death. During a mean follow-up of
25.2 months, 2070 (75.6%) patients were free from AF after catheter
ablation, and the primary composite endpoint occurred in 122 (4.5%)
patients. The AF nonrecurrence group had a significantly lower incidence
of the primary endpoint (1.7 per 100 person-years) compared with the AF
recurrence group (3.2 per 100 person-years; P = 0.001). The multivariate
analysis revealed that freedom from AF (hazard ratio 0.57; 95%
confidence interval 0.39–0.83; P = 0.003) was independently associated
with the incidence of the composite event.¬¬ Conclusion: In the
multicenter cohort of AF ablation, sinus rhythm maintenance after
catheter ablation was independently associated with lower rates of major
adverse cardiac and cerebrovascular events.
Impact of sinus rhythm maintenance on major adverse cardiac and cerebrovascular events after catheter ablation of atrial fibrillation: insights from AF frontier ablation registry
