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Atrial fibrillation ablation patients have long-term stroke rates similar to patients without atrial fibrillation regardless of CHADS2 score.
- Source :
-
Heart rhythm [Heart Rhythm] 2013 Sep; Vol. 10 (9), pp. 1272-7. Date of Electronic Publication: 2013 Jul 05. - Publication Year :
- 2013
-
Abstract
- Background: Atrial fibrillation (AF) is a leading cause of total and fatal ischemic stroke. Stroke risk after AF ablation appears to be favorably affected; however, it is largely unknown whether the benefit extends to all stroke CHADS2 risk profiles of AF patients.<br />Objective: To determine if ablation of atrial fibrillation reduces stroke rates in all risk groups.<br />Methods: A total of 4212 consecutive patients who underwent AF ablation were compared (1:4) with 16,848 age-/sex-matched controls with AF (no ablation) and to 16,848 age-/sex-matched controls without AF. Patients were enrolled from the large ongoing prospective Intermountain Atrial Fibrillation Study and were followed for at least 3 years.<br />Results: Of the 37,908 patients, the mean age was 65.0 ± 13 years and 4.4% (no AF), 6.3% (AF, no ablation), and 4.5% (AF ablation) patients had a prior stroke (P < .0001). The profile of CHADS2 scores between comparative groups was similar: 0-1 (69.3%, no AF; 62.3%, AF, no ablation; 63.6%, AF ablation), 2-3 (26.5%, no AF; 29.7%, AF, no ablation; 28.7%, AF ablation), and ≥4 (4.3%, no AF; 8.0%, AF, no ablation; 7.7%, AF ablation). A total of 1296 (3.4%) patients had a stroke over the follow-up period. Across all CHADS2 profiles and ages, AF patients with ablation had a lower long-term risk of stroke compared to patients without ablation. Furthermore, AF ablation patients had similar long-term risks of stroke across all CHADS2 profiles and ages compared to patients with no history of AF.<br />Conclusions: In our study populations, AF ablation patients have a significantly lower risk of stroke compared to AF patients who do not undergo ablation independent of baseline stroke risk score.<br /> (Copyright © 2013 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Atrial Fibrillation prevention & control
Catheter Ablation
Comorbidity
Female
Heart Failure epidemiology
Humans
Hyperlipidemias epidemiology
Hypertension epidemiology
Male
Middle Aged
Risk Assessment
Risk Factors
Atrial Fibrillation epidemiology
Atrial Fibrillation surgery
Stroke epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1556-3871
- Volume :
- 10
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Heart rhythm
- Publication Type :
- Academic Journal
- Accession number :
- 23835257
- Full Text :
- https://doi.org/10.1016/j.hrthm.2013.07.002