Atrial fibrillation history impact on catheter ablation outcome. Findings from the ESC‐EHRA Atrial Fibrillation Ablation Long‐Term Registry

Stabile, Giuseppe; Trines, Serge A.; Arbelo, Elena; Dagres, Nikolaos; Brugada, Josép; Kautzner, Josef; Pokushalov, Evgeny; Maggioni, Aldo P.; Laroche, Cécile; Anselmino, Matteo; Beinart, Roy; Traykov, Vassil; Lundqvist, Carina Blomström

doi:10.1111/pace.13600

Cited by 10 publications

(11 citation statements)

References 20 publications

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“…I firmly agreed with the authors that atrial fibrillation (AF) history duration >2 years, overall ablation procedure duration, hypertension, and chronic kidney disease were all predictors of recurrences after the blanking period …”

supporting

confidence: 69%

Atrial fibrillation history impact on catheter ablation outcome. Findings from the ESC‐EHRA AF Ablation Long‐Term Registry

Turco

2019

Pacing Clinical Electrophis

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supporting

confidence: 69%

Atrial fibrillation history impact on catheter ablation outcome. Findings from the ESC‐EHRA AF Ablation Long‐Term Registry

Turco

2019

Pacing Clinical Electrophis

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“…16 On the other hand, effective treatment may be more difficult in patients with a long AF history, which is associated with a greater disease burden. 4,5,18 Here, we report for the first time, the efficacy and safety of an AAD in patients with AF/AFL by duration of their disease An association between extended AF/AFL history and AF progression has been reported. 19 In this analysis, although CHA 2 DS 2 -VASc scores were similarly distributed across AF/AFL history groups, patients with long AF/AFL history had a greater burden of AF/AFL and other CV comorbidities including left atrial enlargement at baseline, compared with patients with short AF/AFL history.…”

Section: Discussionmentioning

confidence: 73%

“…Patients with longer durations of AF history have been shown to have worse outcomes with regard to cardioversion and ablation. 4,5 The impact of the duration of AF history on the efficacy and safety of commonly used antiarrhythmic drugs (AADs), however, has not been reported.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of dronedarone by atrial fibrillation history duration: Insights from theATHENAstudy

Blomström‐Lundqvist

Marrouche

Connolly

et al. 2020

Clinical Cardiology

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Background: Atrial fibrillation/atrial flutter (AF/AFL) burden increases with increasing duration of AF/AFL history. Hypothesis: Outcomes with dronedarone may also be impacted by duration of AF/AFL history. Methods: In this post hoc analysis of ATHENA, efficacy and safety of dronedarone vs placebo were assessed in groups categorized by time from first known AF/AFL episode to randomization (ie, duration of AF/AFL history): <3 months (short), 3 to <24 months (intermediate), and ≥ 24 months (long). Results: Of 2859 patients with data on duration of AF/AFL history, 45.3%, 29.6%, and 25.1% had short, intermediate, and long histories, respectively. Patients in the long history group had the highest prevalence of structural heart disease and were more likely to be in AF/AFL at baseline. Placebo-treated patients in the long history group also had the highest incidence of AF/AFL recurrence and cardiovascular (CV) hospitalization during the study. The risk of first CV hospitalization/death from any cause was lower with dronedarone vs placebo in patients with short (hazard ratio, 0.79 [95% confidence interval: 0.65-0.96]) and intermediate (0.72 [0.56-0.92]) histories; a trend favoring dronedarone was also observed in patients with long history (0.84 [0.66-1.07]). A similar pattern was observed for first AF/AFL recurrence. No new drug-related safety issues were identified. Conclusions: Patients with long AF/AFL history had the highest burden of AF/AFL at baseline and during the study. Dronedarone significantly improved efficacy vs placebo in patients with short and intermediate AF/AFL histories. While exploratory, these results support the potential value in initiating rhythm control treatment early in patients with AF/AFL.

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“…The AF duration has been considered an important prognostic factor for the rhythm outcome after a maze procedure 10 or AF ablation 11 . However, AF is less consistent with symptoms and asymptomatic subclinical AF is common.…”

Section: Introductionmentioning

confidence: 99%

Persistent atrial fibrillation over 3 years is associated with higher recurrence after catheter ablation

Kim

et al. 2020

Cardiovasc electrophysiol

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Instruction: Longer atrial fibrillation (AF) durations have higher recurrence rates after rhythm control. However, there is limited data on the effect of the AF duration on recurrence after atrial fibrillation catheter ablation (AFCA). In the present study, we investigated the rhythm outcome of AFCA according to the AF duration based on the first electrocardiogram (ECG) diagnosis. Methods and Results:We included 1005 patients with AF (75% male, 59 ± 11 years old) who underwent AFCA and whose first ECG diagnosis time point was evident. The clinical characteristics and rhythm outcomes were compared based on the AF duration (≤3 years, n = 537; >3 years, n = 468) and AF burden (paroxysmal atrial fibrillation [PAF], n = 387; persistent atrial fibrillation [PeAF], n = 618). Longer AF durations were associated with older age (P = .020), larger left atrial size (P = .009) and a higher number of patients with hypertension (P < .001) or PeAF (P < .001). During 24 ± 22 months of follow-up, the postablation clinical recurrence rate was higher in patients with a longer AF duration (logrank P = .002). The AF recurrence rate was significantly higher in PeAF patients with an AF duration >3 years (logrank P = 0.009), but not in subjects with PAF (logrank P = .939). In a multivariate Cox regression analysis, a longer AF duration was significantly associated with a higher clinical recurrence rate after AFCA in PeAF patients (adjusted hazard ratio, 1.06; range, 1.03-0.10; P = 0.001), but not PAF.Conclusion: Although longer AF duration was associated with higher clinical recurrence rates after AFCA, the rate was significant in patients with PeAF lasting >3 years, but not in PAF patients. K E Y W O R D Satrial fibrillation, catheter ablation, duration, persistent, recurrence

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Atrial fibrillation history impact on catheter ablation outcome. Findings from the ESC‐EHRA Atrial Fibrillation Ablation Long‐Term Registry

Cited by 10 publications

References 20 publications

Atrial fibrillation history impact on catheter ablation outcome. Findings from the ESC‐EHRA AF Ablation Long‐Term Registry

Atrial fibrillation history impact on catheter ablation outcome. Findings from the ESC‐EHRA AF Ablation Long‐Term Registry

Efficacy and safety of dronedarone by atrial fibrillation history duration: Insights from theATHENAstudy

Persistent atrial fibrillation over 3 years is associated with higher recurrence after catheter ablation

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