Successful catheter ablation reduces the risk of cardiovascular events in atrial fibrillation patients with CHA2DS2-VASc risk score of 1 and higher

Yenn Jiang Lin, Tze Fan Chao, Hsuan Ming Tsao, Shih Lin Chang, Li Wei Lo, Chern En Chiang, Yu Feng Hu, Pai Feng Hsu, Shao Yuan Chuang, Cheng Hung Li, Fa Po Chung, Yun Yu Chen, Tsu Juey Wu, Ming Hsiung Hsieh, Shih Ann Chen

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41 Citations (Scopus)

Abstract

Aims It is not known if successful catheter ablation for atrial fibrillation (AF) improves the patient's long-term cardiovascular outcomes. This study investigated the long-term outcomes and mortality of AF patients at high risk who received antiarrhythmic medication and catheter ablation. Methods and results The propensity scores for AF were calculated for each patient and were used to assemble a cohort of 174 AF patients with ablation who were compared with an equal number of AF patients without ablation. Composite cardiovascular end points (major adverse cardiovascular event, MACE), including mortality and vascular events in the medically treated patients representing the control group (group 1), were compared with those in the ablation-treated patients (group 2). The rates of the total mortality (2.95% vs. 0.74% per year; P <0.01), cardiovascular death (1.77% vs. 0% per year; P = 0.001), and ischaemic stroke/transient ischaemic attack (2.21% vs. 0.59% per year; P = 0.02) were higher in group 1 than group 2, respectively. A multivariate Cox regression analysis of the MACE scores showed that a higher CHA2DS 2-VASc score [hazard ratio (HR) = 1.309 per increment of score, 95% confidence interval (CI) = 1.06-1.617; P = 0.01] and the performance of the ablation procedure (HR = 0.225, CI = 0.076-0.671; P = 0.007) were independent predictors of a MACE. In patients who received catheter ablation, recurrence of any atrial arrhythmia was a predictor of vascular events and total mortality (P <0.05). Conclusion In AF patients with CHA2DS2-VASc score ≥1, catheter ablation of AF reduced the risk of the total/cardiovascular mortality and total vascular events. Atrial fibrillation recurrence predicts long-term cardiovascular outcomes, as well as the CHA 2DS2-VASc score.

Original languageEnglish
Pages (from-to)676-684
Number of pages9
JournalEuropace
Volume15
Issue number5
DOIs
Publication statusPublished - May 2013

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Mortality
  • Thromboembolic events
  • Vascular events

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Lin, Y. J., Chao, T. F., Tsao, H. M., Chang, S. L., Lo, L. W., Chiang, C. E., Hu, Y. F., Hsu, P. F., Chuang, S. Y., Li, C. H., Chung, F. P., Chen, Y. Y., Wu, T. J., Hsieh, M. H., & Chen, S. A. (2013). Successful catheter ablation reduces the risk of cardiovascular events in atrial fibrillation patients with CHA2DS2-VASc risk score of 1 and higher. Europace, 15(5), 676-684. https://doi.org/10.1093/europace/eus336