Arrhythmias & electrophysiologyCohort study
Catheter ablation and risk of major adverse cardiovascular events in high-risk patients with newly diagnosed atrial fibrillation: a target trial emulation
- target trial emulation
- Propensity score matching (1:1)
- landmark design with 1-year follow-up starting on Day 366
- TriNetX database
Authors' conclusion
In this study, catheter ablation was associated with a lower risk of MACE and heart failure in high-risk patients with newly diagnosed AF. These findings should be interpreted in the context of the selected study population.
Study context
- Population
- Adults with newly diagnosed atrial fibrillation (AF) between 1 January 2015 and 30 April 2022, excluding prior stroke, prior cardiovascular events or valvular heart diseaseeligible patients, 2018 (0.8%) underwent catheter ablation, after matching, each group included 2018 patients
- Participants
- 263,329 adults
- Exposure
- ablation vs non-ablation cohorts
- ablationn = 2,018
- non-ablationn = 2,018reference
- Outcome
- Major adverse cardiovascular events (MACE)
- Follow-up
- 1-year starting on Day 366
Main finding
As reported in the abstract
Hazard ratio
0.420
95% CI 0.294–0.600
By group
ablation vs non-ablation
HR 0.420 (95% CI 0.294–0.600)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Heart failure · lower risk with ablation | 0.627 (0.494–0.797) | |
| 0.512Hazard ratio (log scale) |
Sensitivity and subgroup analyses
- Findings were consistent in the sensitivity analysis and subgroup analyses
Original publication
Catheter ablation and risk of major adverse cardiovascular events in high-risk patients with newly diagnosed atrial fibrillation: a target trial emulation. Heart. Published 8 May 2026. doi:10.1136/heartjnl-2025-327113
Summarised from the published abstract; every number is checked against it