Abstract
Abstract 4342979: Early vs Delayed Ablation for New-Onset Atrial Fibrillation
Circulation (New York, N.Y.), Vol.152(Suppl_3), pp.A4342979-A4342979
11/04/2025
DOI: 10.1161/circ.152.suppl_3.4342979
Abstract
Background: Recent updated guidelines recognize catheter ablation as a first-line therapy for symptomatic atrial fibrillation (AF). The optimal timing of catheter ablation following AF diagnosis remains uncertain. This study assessed the impact of diagnosis-to-ablation time (DAT) <1 year versus DAT ≥1 year on AF recurrence and adverse clinical outcomes.
Hypothesis: We hypothesize that earlier DAT reduces AF recurrence and adverse outcomes by decreasing atrial remodeling associated with AF.
Methods: We queried the TriNetX research network for patients ≥18 years of age with AF who underwent ablation between January 1, 2010, and June 30, 2019. Patients were stratified based on DAT <1 year vs. DAT ≥1 year and matched using 1:1 propensity scoring for relevant factors. The primary outcome was AF recurrence, defined as a composite of cardioversion, antiarrhythmic drug (AAD) use, or re-ablation at 3 and 5 years, after a 3-month blanking period. Secondary outcomes included a composite of heart failure exacerbation, ischemic stroke, all-cause hospitalization, and mortality along with individual components.
Results: A total of 17,683 patients with DAT <1 year and 13,939 patients with DAT ≥1 year were identified. Propensity matching (1:1) resulted in 9,566 patients in each cohort. The two cohorts were balanced for all baseline covariates except index age, with DAT≥1 being marginally older (63.2 ± 10.0 vs. 63.5 ±10.1, p=0.026). DAT <1 year was associated with significantly lower AF recurrence both at 3 years (adjusted OR: 0.725; 95% CI: 0.683-0.770; p<0.001) and 5 years (adjusted OR: 0.707; 95% CI: 0.667-0.750; p<0.001). The secondary composite outcome was also significantly lower in the DAT <1 year group both at 3 years (adjusted OR 0.84 [95% CI: 0.78-0.89]; p < 0.001) and 5 years (adjusted OR 0.80 [95% CI: 0.76-0.85]; p < 0.001). At 3 years, secondary individual outcomes significantly reduced in the DAT <1 year group included cardioversion, AAD use, ischemic stroke, and all-cause hospitalization. At 5 years, secondary individual outcomes significantly reduced in the DAT <1 year group included cardioversion, re-ablation, AAD use, heart failure exacerbation, ischemic stroke, and all-cause hospitalization. (Figure)
Conclusion: Catheter ablation within one year of AF diagnosis is associated with reduced AF recurrence and major adverse clinical outcomes. These findings support early referral for ablation to improve long-term outcomes.
Details
- Title: Subtitle
- Abstract 4342979: Early vs Delayed Ablation for New-Onset Atrial Fibrillation
- Creators
- Jacob Heath - University of IowaSangwoo Han - University of California, IrvineAshraf Alzahrani - University of IowaDavid Hamon - University of IowaEdward Powers - University of IowaSergio Conti - University of IowaPeter Farjo - University of IowaPaari Dominic - University of Iowa
- Resource Type
- Abstract
- Publication Details
- Circulation (New York, N.Y.), Vol.152(Suppl_3), pp.A4342979-A4342979
- DOI
- 10.1161/circ.152.suppl_3.4342979
- ISSN
- 0009-7322
- eISSN
- 1524-4539
- Publisher
- Lippincott Williams & Wilkins
- Language
- English
- Date published
- 11/04/2025
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9985024265602771
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