Diagnosis-to-ablation time predicts recurrent atrial fibrillation and rehospitalization following catheter ablation.

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dc.contributor.author

Chew, Derek S

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Jones, Kelley A

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Loring, Zak

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Black-Maier, Eric

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Noseworthy, Peter A

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Exner, Derek V

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Packer, Douglas L

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Grant, Jennifer

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Mark, Daniel B

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Piccini, Jonathan P

dc.date.accessioned

2022-08-01T13:11:51Z

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2022-08-01T13:11:51Z

dc.date.issued

2022-02

dc.date.updated

2022-08-01T13:11:49Z

dc.description.abstract

Background

Wait times for catheter ablation in patients with symptomatic atrial fibrillation (AF) may influence clinical outcomes.

Objective

This study examined the relationship between the duration from AF diagnosis to ablation, or diagnosis-to-ablation time (DAT), on the clinical response to catheter ablation in a large nationwide cohort of patients.

Methods

We identified patients with new AF who underwent catheter ablation between January 2014 and December 2017 using the IBM MarketScan databases. Cox proportional hazard models were used to estimate the strength of the association between DAT and the outcomes of AF recurrence and hospitalization at 1 year postablation.

Results

Among 11,143 AF patients who underwent ablation, the median age was 59 years, 31% were female, and the median CHA2DS2-VASc score was 2. Median DAT was 5.5 (2.6, 13.1) months. At 1 year postablation, 10.0% (n = 1116) developed recurrent AF. For each year increase in DAT, the risk of AF recurrence increased by 20% after adjustment for baseline comorbidities and medications (hazard ratio [HR] 1.20, 95% confidence interval [CI] 1.11-1.30). A longer DAT was associated with an increased risk of hospitalization (HR 1.08 per DAT year, 95% CI 1.02-1.15). DAT was a stronger predictor of AF recurrence postablation than traditional clinical risk factors, including age, prior heart failure, or renal failure.

Conclusion

Increasing duration between AF diagnosis and catheter ablation is associated with higher AF recurrence rates and all-cause hospitalization. Our findings are consistent with a growing body of evidence supporting the benefits of prioritizing early restoration of sinus rhythm.
dc.identifier

S2666-5018(21)00222-1

dc.identifier.issn

2666-5018

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2666-5018

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https://hdl.handle.net/10161/25524

dc.language

eng

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Elsevier BV

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Heart rhythm O2

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10.1016/j.hroo.2021.11.012

dc.subject

Atrial fibrillation

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Catheter ablation

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Predictors

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Recurrence

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Rehospitalization

dc.title

Diagnosis-to-ablation time predicts recurrent atrial fibrillation and rehospitalization following catheter ablation.

dc.type

Journal article

duke.contributor.orcid

Loring, Zak|0000-0002-4613-582X

duke.contributor.orcid

Mark, Daniel B|0000-0001-6340-8087

duke.contributor.orcid

Piccini, Jonathan P|0000-0003-0772-2404

pubs.begin-page

23

pubs.end-page

31

pubs.issue

1

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Duke

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School of Medicine

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Basic Science Departments

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Clinical Science Departments

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Institutes and Centers

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Medicine

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Medicine, Cardiology

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Duke Clinical Research Institute

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Population Health Sciences

pubs.publication-status

Published

pubs.volume

3

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