Asthma is Associated with Higher Recurrence Rates of Atrial Fibrillation Following Catheter Ablation.

Abstract

Background: Asthma is a known risk factor for atrial fibrillation (AF), the most common sustained arrhythmia. While radiofrequency catheter ablation is effective in treating AF, the impact of asthma and its severity on ablation outcomes has not been previously explored.

Objective: To evaluate the impact of asthma and its severity on AF recurrence following ablation.

Methods: In this single-center retrospective case control study, 63 cases with AF and asthma who underwent ablation were matched with 126 controls with AF but without asthma who underwent ablation. Cases were also compared to a non-ablated cohort of patients with asthma. AF recurrence was compared between groups. Univariate and multivariate analyses were conducted to determine associations with recurrence.

Results: Compared to controls who underwent ablation, patients with asthma, particularly those with severe asthma, had a higher likelihood of AF recurrence following catheter ablation (OR 3.76, p=0.047 and OR 5.06, p=0.041, respectively). However, cases were not more likely to experience adverse outcomes. Multivariate analysis revealed that persistent AF and use of a beta-blocker were associated with recurrence. Patients with moderate or severe persistent asthma were more likely to have left atrial enlargement compared to patients with intermittent or mild persistent asthma (OR 2.53, p=0.009).

Conclusion: Patients with AF and asthma, particularly those with severe asthma, were more likely than patients with AF but without asthma to have AF recurrence following ablation. Patients with AF and severe asthma were also more likely to have severe LAE, a known predictor of recurrence following ablation.