Longer diagnosis‐to‐ablation time is associated with recurrence of atrial fibrillation after catheter ablation—Systematic review and meta‐analysis

Abstract

Background Diagnosis‐to‐ablation time (DTAT) has been postulated to be one of the predictors of atrial fibrillation (AF) recurrence, and it is a “modifiable” risk factor unlike that of many electrocardiographic or echocardiographic parameters. This development may change our consideration for ablation. In this systematic review and meta‐analysis, we aim to analyze the latest evidence on the importance of DTAT and whether they predict the AF recurrence after catheter ablation. Methods We performed a comprehensive search on topics that assess diagnosis‐to‐ablation time (DTAT) and AF recurrence from inception up until August 2019 through PubMed, EuropePMC, Cochrane Central Database, and http://ClinicalTrials.gov. Results There was a total of 3548 patients from six studies. Longer DTAT was associated with increased risk for AF recurrence in all studies included. Meta‐analysis of these studies showed that DTAT had a hazard ratio (HR) of 1.19 [1.02, 1.39], P = .03; I2: 92% for AF recurrence. Upon sensitivity analysis by removing a study, HR became 1.24 [1.16, 1.32], P < .001; I2: 29%. Meta‐analysis on DTAT time >3 years had HR 1.73 [1.54, 1.93], P < .001; I2: 45% for the recurrence of AF. Upon subgroup analysis of data that compared >6 years to <1 year, the HR was 1.93 [1.62, 2.29], P < .001; I2: 0%. Conclusion Longer DTAT time is associated with an increased risk of AF recurrence. Hence, determining management at the earliest possible moment to avoid delay is of utmost importance.

BMI and atrial fibrillation recurrence post catheter ablation: A dose‐response meta‐analysis

“…In this meta-analysis, we also evaluate whether diagnosisto-ablation time and heart failure, which are shown to affect AF recurrence, 47,48 influence the association between obesity and AF recurrence. The regression analysis showed that the aforementioned covariates did not significantly influence the association.…”

Cryoballoon ablation for paroxysmal atrial fibrillation: mid‐term outcome evaluated by ECG monitoring with an implantable loop recorder

“…CFRF vs. cryoenergy), the difference in the clinical outcomes might be at least partially explained by the relatively short mean time from the first AF episode to PVI in the C2C study (15 months), when compared to our study population (51.5 ± 46.9 months). Recent evidence, 21–24 in fact, suggests that an increased time between the first diagnosis of AF and catheter ablation might adversely affect long‐term outcomes, increasing the risk of AF recurrence in the follow‐up.…”

Atrial cardiomyopathy — a new concept with a long history

“…Комбинированная оценка этиологических факторов и признаков, ассоциированных с ПКМ, может быть полезной информацией при выборе стартовой медикаментозной терапии, в то время как анализ степени фиброза, электрических свойств и функции ЛП могут иметь решающее значение при выборе инвазивных методов лечения. Так, электромеханические и структурные (фиброз) маркеры ПКМ продемонстрировали прогностическую значимость в оценке риска рецидивирования ФП после катетерной РЧА в ряде исследований [49][50][51]. Результаты этих иссле дований дополняют наши знания, показывают связь между ремоделированием предсердий и эффектив ностью РЧА.…”