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

Research output: Contribution to journalArticle

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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

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Catheter Ablation
Atrial Fibrillation
Mortality
Blood Vessels
Confidence Intervals
Recurrence
Propensity Score
Transient Ischemic Attack
Cardiac Arrhythmias
Stroke
Regression Analysis
Control Groups

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Successful catheter ablation reduces the risk of cardiovascular events in atrial fibrillation patients with CHA2DS2-VASc risk score of 1 and higher. / Lin, Yenn Jiang; Chao, Tze Fan; Tsao, Hsuan Ming; Chang, Shih Lin; Lo, Li Wei; Chiang, Chern En; Hu, Yu Feng; Hsu, Pai Feng; Chuang, Shao Yuan; Li, Cheng Hung; Chung, Fa Po; Chen, Yun Yu; Wu, Tsu Juey; Hsieh, Ming Hsiung; Chen, Shih Ann.

In: Europace, Vol. 15, No. 5, 05.2013, p. 676-684.

Research output: Contribution to journalArticle

Lin, YJ, Chao, TF, Tsao, HM, Chang, SL, Lo, LW, Chiang, CE, Hu, YF, Hsu, PF, Chuang, SY, Li, CH, Chung, FP, Chen, YY, Wu, TJ, Hsieh, MH & Chen, SA 2013, 'Successful catheter ablation reduces the risk of cardiovascular events in atrial fibrillation patients with CHA2DS2-VASc risk score of 1 and higher', Europace, vol. 15, no. 5, pp. 676-684. https://doi.org/10.1093/europace/eus336
Lin, Yenn Jiang ; Chao, Tze Fan ; Tsao, Hsuan Ming ; Chang, Shih Lin ; Lo, Li Wei ; Chiang, Chern En ; Hu, Yu Feng ; Hsu, Pai Feng ; Chuang, Shao Yuan ; Li, Cheng Hung ; Chung, Fa Po ; Chen, Yun Yu ; Wu, Tsu Juey ; Hsieh, Ming Hsiung ; Chen, Shih Ann. / Successful catheter ablation reduces the risk of cardiovascular events in atrial fibrillation patients with CHA2DS2-VASc risk score of 1 and higher. In: Europace. 2013 ; Vol. 15, No. 5. pp. 676-684.
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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.",
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T1 - Successful catheter ablation reduces the risk of cardiovascular events in atrial fibrillation patients with CHA2DS2-VASc risk score of 1 and higher

AU - Lin, Yenn Jiang

AU - Chao, Tze Fan

AU - Tsao, Hsuan Ming

AU - Chang, Shih Lin

AU - Lo, Li Wei

AU - Chiang, Chern En

AU - Hu, Yu Feng

AU - Hsu, Pai Feng

AU - Chuang, Shao Yuan

AU - Li, Cheng Hung

AU - Chung, Fa Po

AU - Chen, Yun Yu

AU - Wu, Tsu Juey

AU - Hsieh, Ming Hsiung

AU - Chen, Shih Ann

PY - 2013/5

Y1 - 2013/5

N2 - 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.

AB - 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.

KW - Atrial fibrillation

KW - Catheter ablation

KW - Mortality

KW - Thromboembolic events

KW - Vascular events

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