Catheter Ablation Outcomes and Life Expectancy in Very Elderly Atrial Fibrillation Patients: The REHEALTH AF Study

Hirata, S; Okumura, Y; Nagashima, K; Watanabe, R; Yokoyama, K; Matsumoto, N; Kato, T; Fukaya, H; Hayashi, H; Nakahara, S; Shimizu, W; Iwasaki, YK; Fujimoto, Y; Mukai, Y; Ejima, K; Otsuka, T; Suzuki, S; Murakami, M; Kimura, M; Harada, M; Koyama, J; Yamane, T; Tokuda, M; Takami, M; Shoda, M; Harada, T; Nakajima, I; Hiroshima, K; Tanimoto, K; Kumagai, K; Okada, A; Kobayashi, H; Watari, Y; Hatsuno, M; Hayashi, T; Tachibana, E; Iso, K; Sonoda, K; Aizawa, Y; Fukuoka, R; Chikata, A; Inoue, M; Sakagami, S; Minamiguchi, H; Makino, N; Ichikawa, M; Haruta, H; Hiro, T; Okubo, K; Arai, M; Arima, K; Kihara, H; Miyanaga, S; Fukuda, Y; Oiwa, K; Koyama, Y; Kurihara, T; Akabane, M; Ishikawa, N; Kusano, K; Miyamoto, K; Tabuchi, H; Shiozawa, T; Miyamoto, K; Mase, H; Murotani, K

doi:10.1016/j.jacep.2025.10.007

Catheter Ablation Outcomes and Life Expectancy in Very Elderly Atrial Fibrillation Patients: The REHEALTH Atrial Fibrillation (AF) Study

JACC Clin ElectrophysiolPublished 24 Nov 2025Prospective registry-based observational study

Main finding · Composite of stroke, TIA, systemic embolism, CV events, bleeding or all-cause deathResultAdjusted hazard ratio 0.44

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Authors' conclusion

Although ablation improved functional and structural outcomes, its prognostic benefit was limited without adjustment but emerged after multivariable correction.

Study context

Population: Patients aged ≥80 years with nonvalvular AF, 47 hospitals in Japan, June 2022–December 2023
Participants: 703 patients

Exposure: Catheter ablation vs nonablation management
Ablationn = 249
Nonablationn = 454reference
Outcome: Composite of:
Stroke
TIA
Systemic embolism
CV events
Bleeding
All-cause death
Follow-up: Median 504 days (Q1-Q3: 375-667 days)

Methodological detailsmulticentre, 47 hospitals in Japan

Multicentre
47 hospitals in Japan

Main finding

As reported in the abstract

Adjusted hazard ratio

0.44

P = 0.029

Observational data: associations, not effects.

Further findings

Symptoms, quality of life, NT-proBNP, left atrial diameter, Mini-Mental State Examination and frailty scores · 1 year

Ablation improved symptoms, quality of life, NT-proBNP and left atrial diameter, with better preservation of MMSE and frailty scores; significant after adjustment

Reference

Authors: Hirata S, Okumura Y, Nagashima K, Watanabe R, Yokoyama K, Matsumoto N, et al.
All 66 authors
Hirata S, Okumura Y, Nagashima K, Watanabe R, Yokoyama K, Matsumoto N, Kato T, Fukaya H, Hayashi H, Nakahara S, Shimizu W, Iwasaki YK, Fujimoto Y, Mukai Y, Ejima K, Otsuka T, Suzuki S, Murakami M, Kimura M, Harada M, Koyama J, Yamane T, Tokuda M, Takami M, Shoda M, Harada T, Nakajima I, Hiroshima K, Tanimoto K, Kumagai K, Okada A, Kobayashi H, Watari Y, Hatsuno M, Hayashi T, Tachibana E, Iso K, Sonoda K, Aizawa Y, Fukuoka R, Chikata A, Inoue M, Sakagami S, Minamiguchi H, Makino N, Ichikawa M, Haruta H, Hiro T, Okubo K, Arai M, Arima K, Kihara H, Miyanaga S, Fukuda Y, Oiwa K, Koyama Y, Kurihara T, Akabane M, Ishikawa N, Kusano K, Miyamoto K, Tabuchi H, Shiozawa T, Miyamoto K, Mase H, Murotani K
Journal: JACC: Clinical Electrophysiology
Published: 24 Nov 2025
DOI: 10.1016/j.jacep.2025.10.007
PubMed: 41288543
Registration: UMIN000047023

Country: Japan
Topic: Arrhythmias & electrophysiology

Key notes

Did not differ between groups, unmatched cohort (HR: 0.78; P = 0.30)
Did not differ between groups, matched cohort (HR: 0.65; P = 0.21)

More notes

Matched cohort, multivariable adjustment for log-NT-proBNP and albumin
Matched cohort

Original publication

Catheter Ablation Outcomes and Life Expectancy in Very Elderly Atrial Fibrillation Patients: The REHEALTH AF Study. JACC Clin Electrophysiol. Published 24 November 2025. doi:10.1016/j.jacep.2025.10.007

Read the original article ↗

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