Chronic but not Transient Anemia Is Associated With Atrial Fibrillation Recurrence After Catheter Ablation

IF 1.9 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Arrhythmia Pub Date : 2026-08-12 DOI:10.1002/joa3.70445

Mikkel Guldberg Kasch, Númi Torpe Snæbjörnsson, Lise Da Riis-Vestergaard, Rogina Rached, Daniel Mølager Christensen, Casper Binding, Mariam Elmegaard, Mads Hashiba, Sebastian K. Nielsen, Morten Lambert, Christian Torp-Pedersen, Morten Schou, Gunnar Gislason, Abdullahi Ahmed Mohamed

{"title":"Chronic but not Transient Anemia Is Associated With Atrial Fibrillation Recurrence After Catheter Ablation","authors":"Mikkel Guldberg Kasch, Númi Torpe Snæbjörnsson, Lise Da Riis-Vestergaard, Rogina Rached, Daniel Mølager Christensen, Casper Binding, Mariam Elmegaard, Mads Hashiba, Sebastian K. Nielsen, Morten Lambert, Christian Torp-Pedersen, Morten Schou, Gunnar Gislason, Abdullahi Ahmed Mohamed","doi":"10.1002/joa3.70445","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Anemia is common in patients with atrial fibrillation (AF). Prior studies have associated anemia—based on a single pre-procedural hemoglobin measurement—with AF recurrence after catheter ablation. However, it remains unclear whether chronic anemia confers a different risk compared with transient anemia. This study evaluated the association between transient and chronic anemia and AF recurrence following first-time catheter ablation.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In this nationwide cohort study, we included 15 017 patients from the Danish National Ablation Database undergoing first-time AF ablation between 2010 and 2024 with available hemoglobin measurements within 12 months prior to the procedure. Patients were categorized as having no anemia, transient anemia, or chronic anemia based on repeated hemoglobin measurements. The primary outcome was AF recurrence within 1 year after a 90-day blanking period, defined as a composite of AF-related hospitalization, cardioversion, antiarrhythmic drug use, or repeat ablation. Associations were assessed using multivariable Cox proportional hazards models.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 877 patients (5.8%) had chronic anemia and 1592 (10.6%) had transient anemia. During follow-up, 3445 patients (23.6%) experienced AF recurrence. The 1-year cumulative incidence of recurrence was highest in patients with chronic anemia (32.5%), followed by transient anemia (24.2%) and no anemia (23.0%). Compared with non-anemic patients, chronic anemia was independently associated with an increased risk of AF recurrence (adjusted hazard ratio [HR]: 1.36; 95% confidence interval [CI]: 1.18–1.56), whereas transient anemia was not (HR: 0.98; 95% CI: 0.87–1.10).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Chronic—but not transient—anemia prior to first-time catheter ablation was independently associated with a higher risk of AF recurrence.</p>\n </section>\n </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70445","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Arrhythmia","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/joa3.70445","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Anemia is common in patients with atrial fibrillation (AF). Prior studies have associated anemia—based on a single pre-procedural hemoglobin measurement—with AF recurrence after catheter ablation. However, it remains unclear whether chronic anemia confers a different risk compared with transient anemia. This study evaluated the association between transient and chronic anemia and AF recurrence following first-time catheter ablation.

Methods

In this nationwide cohort study, we included 15 017 patients from the Danish National Ablation Database undergoing first-time AF ablation between 2010 and 2024 with available hemoglobin measurements within 12 months prior to the procedure. Patients were categorized as having no anemia, transient anemia, or chronic anemia based on repeated hemoglobin measurements. The primary outcome was AF recurrence within 1 year after a 90-day blanking period, defined as a composite of AF-related hospitalization, cardioversion, antiarrhythmic drug use, or repeat ablation. Associations were assessed using multivariable Cox proportional hazards models.

Results

A total of 877 patients (5.8%) had chronic anemia and 1592 (10.6%) had transient anemia. During follow-up, 3445 patients (23.6%) experienced AF recurrence. The 1-year cumulative incidence of recurrence was highest in patients with chronic anemia (32.5%), followed by transient anemia (24.2%) and no anemia (23.0%). Compared with non-anemic patients, chronic anemia was independently associated with an increased risk of AF recurrence (adjusted hazard ratio [HR]: 1.36; 95% confidence interval [CI]: 1.18–1.56), whereas transient anemia was not (HR: 0.98; 95% CI: 0.87–1.10).