Mortality and cerebrovascular events after radiofrequency catheter ablation of atrial fibrillation

Ghanbari, Hamid; Baser, Kazim; Jongnarangsin, Krit; Chugh, Aman; Nallamothu, Brahmajee K.; Gillespie, Brenda W.; Başer, Hatice Duygu; Swangasool, Arisara; Crawford, Thomas; Latchamsetty, Rakesh; Good, Eric; Pelosi, Frank; Bogun, Frank; Morady, Fred; Oral, Hakan

doi:10.1016/j.hrthm.2014.05.003

Cited by 47 publications

(22 citation statements)

References 18 publications

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“…Any potential benefit of catheter ablation in the reduction of long-term stroke is possibly counterbalanced against the peri-procedural risk of stroke, which remains a significant complication of AF ablation but was not consistently reported in the observational studies. It has been suggested that successful ablation and restoration of sinus rhythm, although acutely associated with an increase in the risk of silent cerebral emboli, may subsequently decrease embolic burden over time 46 ; however this hypothesis remains controversial, as recently shown by Ghanbari et al 47 , and the results from the present analysis do not lend strong support to the theory of stroke reduction. These observations notwithstanding, it should be highlighted that none of randomized studies were powered to show a benefit of ablation in the reduction of stroke risk.…”

Section: Catheter Ablation Versus Medical Rate Control In Atrial Fibrcontrasting

confidence: 62%

Association of catheter ablation for atrial fibrillation with mortality and stroke: A systematic review and meta-analysis

Barra

Narayanan

Boveda

et al. 2018

International Journal of Cardiology

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Section: Catheter Ablation Versus Medical Rate Control In Atrial Fibrcontrasting

confidence: 62%

Association of catheter ablation for atrial fibrillation with mortality and stroke: A systematic review and meta-analysis

Barra

Narayanan

Boveda

et al. 2018

International Journal of Cardiology

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“…Catheter ablation for AF has been established as an effective therapeutic option for drug‐resistant AF, and maintaining sinus rhythm after catheter ablation has been shown to be associated with a lower rate of cardiovascular mortality 2. Nevertheless, despite continuous improvements in outcomes with advances in ablation techniques, recurrences of atrial arrhythmias remain a common clinical problem following ablation.…”

Section: Introductionmentioning

confidence: 99%

Age‐Dependent Predictive Value of Endothelial Dysfunction for Arrhythmia Recurrence Following Pulmonary Vein Isolation

Matsuzawa

Suleiman

Guddeti

et al. 2016

JAHA

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BackgroundThe mechanisms of atrial fibrillation (AF) are highly divergent. The prevalence of AF increases significantly with age, and underling mechanisms might vary with age. Endothelial dysfunction may be associated with AF and atrial arrhythmia recurrence after catheter ablation. We tested the hypothesis that the impact of endothelial dysfunction on arrhythmia recurrence following catheter ablation is age dependent.Methods and ResultsThis study enrolled 92 participants with AF undergoing catheter ablation. Endothelial function was assessed by peripheral arterial tonometry before ablation, and the natural logarithmic transformation of reactive hyperemia index was calculated. Endothelial dysfunction was defined as a natural logarithmic transformation of reactive hyperemia index <0.618 (median). Participants were followed for atrial tachycardia, flutter, and fibrillation recurrence for a median of 14 months. The mean age was 57±10 years. There was significant interaction between age and endothelial dysfunction in association with recurrence of AF (P=0.029) and any atrial arrhythmia (P=0.015), and the risk associated with endothelial dysfunction for arrhythmia recurrence was higher in younger versus older participants. Participants were divided into 2 age groups at a threshold of 60 years. Among participants aged ≤60 years, multivariate Cox proportional hazards analysis revealed the independent association between endothelial dysfunction and increased risk of arrhythmia recurrence (hazard ratio for AF 4.18 [95% CI 1.33–15.82], P=0.014, and for any atrial arrhythmia 3.62 [95% CI 1.29–11.81], P=0.014). Kaplan–Meier analysis showed that participants with endothelial dysfunction had significantly higher rates of recurrence of AF (P=0.01) and any atrial arrhythmia (P=0.002).ConclusionsThe risk associated with endothelial dysfunction for arrhythmia recurrence following catheter ablation was age dependent and was higher in younger participants.

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“…10 A recent study of RF catheter-based AF ablation found that SR maintenance was associated with a lower risk of cardiac mortality but not all-cause mortality. 27 The Catheter Ablation versus Anti-arrhythmic Drug Therapy for Atrial Fibrillation Trial (CABANA) 28 will hopefully shed light on this issue. The modest rate of long-term SR maintenance in our population may not translate into a significant improvement in survival.…”

Section: Resultsmentioning

confidence: 99%

“…The long‐term survival benefit of concomitant AF ablation at the time of valve surgery remains uncertain . A recent study of RF catheter‐based AF ablation found that SR maintenance was associated with a lower risk of cardiac mortality but not all‐cause mortality . The Catheter Ablation versus Anti‐arrhythmic Drug Therapy for Atrial Fibrillation Trial (CABANA) will hopefully shed light on this issue.…”

Section: Discussionmentioning

confidence: 99%

Concomitant Unipolar Radiofrequency Ablation of Nonparoxysmal Atrial Fibrillation in Rheumatic and Degenerative Valve Disease

et al. 2014

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Mortality and cerebrovascular events after radiofrequency catheter ablation of atrial fibrillation

Cited by 47 publications

References 18 publications

Association of catheter ablation for atrial fibrillation with mortality and stroke: A systematic review and meta-analysis

Association of catheter ablation for atrial fibrillation with mortality and stroke: A systematic review and meta-analysis

Age‐Dependent Predictive Value of Endothelial Dysfunction for Arrhythmia Recurrence Following Pulmonary Vein Isolation

Concomitant Unipolar Radiofrequency Ablation of Nonparoxysmal Atrial Fibrillation in Rheumatic and Degenerative Valve Disease

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