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Prognostic impact of catheter ablation in patients with asymptomatic atrial fibrillation
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 receiv...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9754597/ https://www.ncbi.nlm.nih.gov/pubmed/36520956 http://dx.doi.org/10.1371/journal.pone.0279178 |
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author | Kawaji, Tetsuma Shizuta, Satoshi Tanaka, Munekazu Nishiwaki, Shushi Aizawa, Takanori Yamagami, Shintaro Komasa, Akihiro Yoshizawa, Takashi Kato, Masashi Yokomatsu, Takafumi Miki, Shinji Ono, Koh Kimura, Takeshi |
author_facet | Kawaji, Tetsuma Shizuta, Satoshi Tanaka, Munekazu Nishiwaki, Shushi Aizawa, Takanori Yamagami, Shintaro Komasa, Akihiro Yoshizawa, Takashi Kato, Masashi Yokomatsu, Takafumi Miki, Shinji Ono, Koh Kimura, Takeshi |
author_sort | Kawaji, Tetsuma |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9754597 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-97545972022-12-16 Prognostic impact of catheter ablation in patients with asymptomatic atrial fibrillation Kawaji, Tetsuma Shizuta, Satoshi Tanaka, Munekazu Nishiwaki, Shushi Aizawa, Takanori Yamagami, Shintaro Komasa, Akihiro Yoshizawa, Takashi Kato, Masashi Yokomatsu, Takafumi Miki, Shinji Ono, Koh Kimura, Takeshi PLoS One Research Article 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. Public Library of Science 2022-12-15 /pmc/articles/PMC9754597/ /pubmed/36520956 http://dx.doi.org/10.1371/journal.pone.0279178 Text en © 2022 Kawaji et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Kawaji, Tetsuma Shizuta, Satoshi Tanaka, Munekazu Nishiwaki, Shushi Aizawa, Takanori Yamagami, Shintaro Komasa, Akihiro Yoshizawa, Takashi Kato, Masashi Yokomatsu, Takafumi Miki, Shinji Ono, Koh Kimura, Takeshi Prognostic impact of catheter ablation in patients with asymptomatic atrial fibrillation |
title | Prognostic impact of catheter ablation in patients with asymptomatic atrial fibrillation |
title_full | Prognostic impact of catheter ablation in patients with asymptomatic atrial fibrillation |
title_fullStr | Prognostic impact of catheter ablation in patients with asymptomatic atrial fibrillation |
title_full_unstemmed | Prognostic impact of catheter ablation in patients with asymptomatic atrial fibrillation |
title_short | Prognostic impact of catheter ablation in patients with asymptomatic atrial fibrillation |
title_sort | prognostic impact of catheter ablation in patients with asymptomatic atrial fibrillation |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9754597/ https://www.ncbi.nlm.nih.gov/pubmed/36520956 http://dx.doi.org/10.1371/journal.pone.0279178 |
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