Arrhythmias & electrophysiology
Arrhythmia Recurrence and Rhythm Control Strategies After Catheter Ablation of Newly Diagnosed Atrial Fibrillation (ARRC-AF Study)
Authors' conclusion
In this study, additional rhythm-control strategies were frequently continued after index ablation. One in 6 patients underwent repeat ablation, with the majority receiving concomitant AAD therapy. These data indicate that a combined strategy of catheter ablation and AADs is currently used in practice for rhythm control.
Study context
- Population
- Patients in Optum's deidentified Market Clarity Data who underwent index ablation for newly diagnosed atrial fibrillation (AF) (2007–2021)patients who underwent index ablation, database of 2,429,863 patients
- Participants
- 23,323 patients
- Outcome
- Repeat ablation
- Follow-up
- Median 1,165 days
Main finding
As reported in the abstract
≥2 ablations
3,862
16.6%
2 ablations
14.2%
3 ablations
2.0%
≥4 ablations
0.4%
Observational data: associations, not effects.
Further findings
| Outcome | IRR (95% CI) | |
|---|---|---|
| Factors associated with repeat ablationLong-standing persistentvs paroxysmalAF phenotype | 2.26 (1.27–3.68) | |
| Factors associated with repeat ablationAAD usevs no use | 1.42 (1.30–1.56) | |
| Factors associated with repeat ablationObstructive sleep apneavs no obstructive sleep apnea | 1.26 (1.20–1.33) | |
| Factors associated with repeat ablationValvular heart diseasevs no valvular heart disease | 1.12 (1.07–1.18) | |
| Factors associated with repeat ablationCoronary artery diseasevs no coronary artery disease | 1.13 (1.07–1.19) | |
| Factors associated with repeat ablationBody mass index 30 to 35 kg/m²vs <30 kg/m² | 1.10 (1.02–1.20) | |
| 0.20.5125Incidence rate ratio (log scale) |
Arrhythmia events in patients with repeat ablations
- AF or atrial flutter events (n = 7,907), per patient
- 2.0
- Other coded arrhythmias (n = 2,298), per patient
- 0.6
And antiarrhythmic drug (AAD) use after index ablation
- Overall
- 46.9%
- Among patients with ≥1 repeat ablation
- 62.8% to 92.3%
Original publication
Arrhythmia Recurrence and Rhythm Control Strategies After Catheter Ablation of Newly Diagnosed Atrial Fibrillation (ARRC-AF Study). JACC Clin Electrophysiol. Published 12 February 2025. doi:10.
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