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Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. In addition to antiarrhythmic therapy, radiofrequency catheter ablation (RFA) emerges as a promising approach that offers the benefits of maintaining sinus rhythm. However, the long-term effect of RFA on reducing mortality and the occurrence stroke and heart failure was not fully examined yet.
A retrospective cohort study using the Taiwan National Health Insurance claims database was conducted to identify patients with AF who underwent RFA between 2003 and 2009. An outpatient group of AF patients matched by propensity scores based on age, sex, antiarrhythmic medication, CHADS2 score, and other baseline co-morbidities who did not receive RFA was selected as comparison. The outcomes of interest were death, stroke, heart failure, and hospitalization for either stroke or heart failure. A proportional hazard Cox regression model was applied to estimate the hazard ratio between the two therapeutic options.
A total of 586 AF patients who received RFA and 586 matched controls were included in the analysis, with a mean follow-up 3.60 and 3.44 years, respectively. The incidence rate for death was 10.41 and 14.89 per 1,000 person-years in the RFA and non-RFA groups (p = 0.206). There was a statistically significant reduction in the incidence of stroke in favor of the RFA group (5.21 vs. 13.4 per 1,000 person-years). RFA was associated with a 61% risk reduction for stroke (HR: 0.39, 95% CI: 0.19-0.78, p = 0.008). Despite the difference in the incidence rate for heart failure did not reach statistical significance (p= 0.151), there was also a statistically significant reduction in the hospitalization for either stroke or heart failure (HR: 0.53, 95 % CI: 0.34-0.82, p = 0.004).
The results of this study demonstrate that RFA was associated with a decreased incidence for stroke in AF patients. RFA also reduced the need for future hospitalization due to stroke or heart failure. This study provides new evidence to the long-term beneficial effect of RFA in the management of AF.
Moderated Poster Contributions
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Atrial Fibrillation Ablation
Abstract Category: 4. Arrhythmias: AF/SVT
Presentation Number: 1278M-37
- 2013 American College of Cardiology Foundation