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Diagnosis-to-ablation time in atrial fibrillation: A modifiable factor relevant to clinical outcome.

Abstract：

INTRODUCTION:Recurrences after atrial fibrillation (AF) ablation are still common. Among the reported clinical and imaging predictors of recurrences, diagnosis-to-ablation time (DAT) has been defined as a predictor of ablation outcome in single-center studies. We aimed to validate DAT in a multicenter real-life cohort. METHODS:This was a multicenter study including consecutive patients undergoing first paroxysmal and persistent AF ablation with radiofrequency or cryoballoon catheters during 2013. Cox proportional hazard regression models were performed to identify predictors of recurrence. RESULTS:In total, 309 patients were included across nine centers (71% men, 57 ± 10 years old, 46% with hypertension, and 66% with CHA2 DS2 -VASc ≤ 1). Most patients had paroxysmal AF (67%) and underwent radiofrequency ablation (68%) with a median DAT of 51 (43) months. Patients with DAT ≤ 1 year (16.6%) were less likely to have repeat procedures (4% vs 18%; P = .017). The adjusted proportional hazards Cox model identified hypertension (P = .005), heart failure (P = .011), nonparoxysmal AF (P = .038), DAT > 1 year (P = .007), and LA diameter (P = .026) as independent predictors for AF recurrence. DAT > 1 year was the only modifiable factor independently associated with recurrence (HR 4.2 [95% CI, 1.5-11.9]) CONCLUSION: Diagnosis-to-ablation time is a modifiable factor independently associated with recurrent arrhythmia and repeat ablation after first AF ablation. An early intervention strategy during the first year from AF diagnosis might improve outcomes.

journal_name

J Cardiovasc Electrophysiol

journal_title

Journal of cardiovascular electrophysiology

authors

Bisbal F,Alarcón F,Ferrero-De-Loma-Osorio A,González-Ferrer JJ,Alonso-Martín C,Pachón M,Vallés E,Cabanas-Grandío P,Sanchez M,Benito E,Sarrias A,Ruiz-Granell R,Pérez-Villacastín J,Viñolas X,Arias MA,Martí-Almor J,García-Ca

doi

10.1111/jce.14000

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

1483-1490

issue

9

eissn

1045-3873

issn

1540-8167

journal_volume

30

pub_type

杂志文章,多中心研究

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