Arrhythmias & electrophysiology
Impact of Diagnosis-to-Ablation Time on Atrial Fibrillation (AF) Recurrence: Pronounced the First 3 Years, Irrelevant Thereafter
Authors' conclusion
The association between DAT and AF recurrence has no lower limit ("the shorter the better"), whereas little gain is to be expected beyond 36 months ("the longer the more irrelevant").
Study context
- Population
- Patients with AF undergoing pulmonary vein isolation (PVI), 2005–2014 and 2017–20192 cohorts of 1,000
- Participants
- 2,000 patients
- Exposure
- AF recurrence by diagnosis-to-ablation time
- Outcome
- AF recurrence in relation to DAT
- Follow-up
- 3 years
Methodological details2 cohorts, multivariable Cox proportional hazards model
- 2 cohorts
- Multivariable Cox proportional hazards model
Main finding
As reported in the abstract
AF recurrence vs DAT (range 0-288 months)
Steep rise in AF recurrence in first 36 months (d%/dt = 0.36)
27% to 40%
First inflection point
36 months
Less steep rise until 90 months (d%/dt = 0.09)
45%
Flattening beyond 90 months
d%/dt = 0.026
Observational data: associations, not effects.
Further findings
| Outcome | Values | P value |
|---|---|---|
| Median DAT, first vs second cohort | First cohort Median 36 (IQR 12-72 months) months · Second cohort Median 12 (IQR 5-48 months) months | P < 0.001 |
| AF recurrence rise in first 36 months, by AF type (subgroup) | Persistent AF from 40% to 54% · d%/dt 0.39 · Paroxysmal AF 19% to 29% · d%/dt 0.28 |
Clinical success
- Clinical success
- 61.7%
Original publication
Impact of Diagnosis-to-Ablation Time on AF Recurrence: Pronounced the First 3 Years, Irrelevant Thereafter. JACC Clin Electrophysiol. Published 30 August 2023. doi:10.
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