Impact of Sinus Rhythm Maintenance on Major Adverse Cardiac and Cerebrovascular Events after Catheter Ablation of Atrial Fibrillation: Insights from AF Frontier Ablation Registry

Abstract

Introduction: The impact of catheter ablation for atrial fibrillation (AF) on cardiovascular events and mortality is controversial. We investigated the impact of sinus rhythm maintenance on major adverse cardiac and cerebrovascular events after AF ablation from a Japanese multicenter cohort of AF ablation. Methods and Results: We investigated 2737 consecutive patients (25.6% female, mean age 63.4 ± 10.3 years) who underwent a first catheter ablation for AF from the Atrial Fibrillation registry to Follow the long-teRm Outcomes and use of aNTIcoagulants aftER Ablation (AF Frontier Ablation Registry). The primary endpoint was a composite of stroke, transient ischemic attack, cardiovascular events, and all-cause death. During a mean follow-up of 25.2 months, 2070 (75.6%) patients were free from AF after catheter ablation, and the primary composite endpoint occurred in 122 (4.5%) patients. The AF nonrecurrence group had a significantly lower incidence of the primary endpoint (1.7 per 100 person-years) compared with the AF recurrence group (3.2 per 100 person-years; P = 0.001). The multivariate analysis revealed that freedom from AF (hazard ratio 0.57; 95% confidence interval 0.39–0.83; P = 0.003) was independently associated with the incidence of the composite event.¬¬ Conclusion: In the multicenter cohort of AF ablation, sinus rhythm maintenance after catheter ablation was independently associated with lower rates of major adverse cardiac and cerebrovascular events.

Change and clinical significance of serum cortisol, BNP, and PGE-2 levels in premature infants with patent ductus arteriosus

“…However, the influence mechanism of cortisol on the closure of the arterial catheter is unclear (17). Animal experiments have shown that cortisol can reduce prostaglandin synthesis by inhibiting phospholipase A, and can reduce the sensitivity of the arterial catheter to the prostaglandin expansion effect (18,19). Studies have also found that cortisol itself has a weak contractile effect on the artery (20).…”

Effect of Catheter Ablation for Atrial Fibrillation in Heart Failure With Mid-Range or Preserved Ejection Fraction ― Pooled Analysis of the AF Frontier Ablation Registry and Hokuriku-Plus AF Registry ―

“…According to the Japanese multicenter cohort study of patients with AF after catheter ablation, freedom from AF recurrence after catheter ablation was independently associated with a lower risk of cardiac adverse events or death. 13 Reducing AF burden by successful catheter ablation may improve the adverse hemodynamic state, leading to a reduced risk of heart failure or cardiovascular death in the AF population. In the present study with HFmrEF and HFpEF, the incidence of cardiovascular death or hospitalization for index at rest.…”