1. Effects of antiarrhythmic drug responsiveness and diagnosis‐to‐ablation time on outcomes after catheter ablation for persistent atrial fibrillation
- Author
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Hong‐Ju Kim, Daehoon Kim, Kipoong Kim, Sung Hwa Choi, Moon‐Hyun Kim, Je‐Wook Park, Hee Tae Yu, Tae‐Hoon Kim, Jae‐Sun Uhm, Boyoung Joung, Moon‐Hyoung Lee, and Hui‐Nam Pak
- Subjects
antiarrhythmic responsiveness ,atrial fibrillation ,atrial fibrillation catheter ablation ,atrial fibrillation duration ,clinical recurrence ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background The impact of delaying atrial fibrillation catheter ablation (AFCA) for antiarrhythmic drug (AAD) management on the disease course remains unclear. This study investigated AFCA rhythm outcomes based on the diagnosis‐to‐ablation time (DAT) and AAD responsiveness in participants with persistent AF (PeAF). Methods We included data from 1038 AAD‐resistant PeAF participants, all of whom had a clear time point for AF diagnosis, especially PeAF at diagnosis time, and had undergone an AFCA for the first time. Participants who experienced recurrences of paroxysmal type on AAD therapy were analyzed as a cohort of AAD‐partial responders; those maintaining PeAF on AAD were AAD‐non‐responders. We determined the DAT cutoff for best discriminating long‐term rhythm outcomes using a maximum log‐likelihood estimation method based on the Cox proportional hazard regression model. Results Of the participants (79.8% male; median age 61), 806 (77.6%) were AAD‐non‐responders. AAD‐non‐responders had a higher body mass index and a larger left atrial diameter than AAD‐partial‐responders. They also had a higher incidence of AF recurrence after AFCA (adjusted hazard ratio 1.75, 95% confidence interval 1.33–2.30; log‐rank p
- Published
- 2024
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