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AF ablation confers lower mortality, stroke in cohort study
Davis Health.
In the CAABL-AF population-based study of patients with nonvalvular atrial fibrillation, those treated with catheter ablation had lower rates of stroke and mortality than those who did not have ablation.
“Less than 2% of patients undergo ablation early in the course of AF when the procedure can be most beneficial,” Uma Srivatsa, MBBS, MAS, professor of cardiovascular medicine at UC Davis Health, said in a press release. “Our study shows that ablation may be considered as a primary treatment for everyone with the condition.”
Using databases from California nonfederal hospitals for patients hospitalized between 2005 and 2013, the researchers matched 4,169 patients who underwent ablation for AF with 4,169 patients diagnosed with AF who did not have ablation. Matching was based on age, sex and time alive between diagnosis and ablation date.
Outcomes of interest included mortality, ischemic stroke and hemorrhagic stroke. Mean follow-up was 3.6 years.
After adjustment for demographics, prior admissions for AF, calendar year and chronic comorbidities, compared with controls, the ablation group had lower risk for mortality (0.9% per patient-year vs. 1.9% per patient-year; HR = 0.59; 95% CI, 0.45-0.77), ischemic stroke between 30 days and 5 years (0.37% vs. 0.59%; HR = 0.68; 95% CI, 0.47-0.97) and hemorrhagic stroke (0.11% vs. 0.35%; HR = 0.36; 95% CI, 0.2-0.64), according to the researchers.
“Our data support wider utilization of ablation along with improving the awareness of its benefits,” Srivatsa said in the release.
In a related editorial, Maria Terricabras, MD, and Atul Verma, MD, both from Southwest Regional Health Centre, University of Toronto, Newmarket, Ontario, Canada, wrote: “The authors reinforce the hypothesis already presented by large retrospective studies of a mortality and stroke reduction benefit in patients with AF treated with ablation. However, the study has the limitations of a retrospective case-control study, where adjustment between both cohorts cannot fully neutralize unknown confounding factors, which can only be done in a randomized trial.” – by Erik Swain
Disclosures: The authors and Terricabras report no relevant financial disclosures. Verma reports he received research grants from Bayer, Biosense Webster, Biotronik and Medtronic.