Yi-Kai Cui, Jian-Zeng Dong, Xin Du, Rong Hu, Liu He, De-Yong Long, Rong Bai, Rong-Hui Yu, Cai-Hua Sang, Chen-Xi Jiang, Nian Liu, Song-Nan Li, Wei Wang, Xue-Yuan Guo, Xin Zhao, Song Zuo, Ri-Bo Tang, Chang-Sheng Ma
{"title":"Outcome of catheter ablation for paroxysmal atrial fibrillation in patients with stable coronary artery disease.","authors":"Yi-Kai Cui, Jian-Zeng Dong, Xin Du, Rong Hu, Liu He, De-Yong Long, Rong Bai, Rong-Hui Yu, Cai-Hua Sang, Chen-Xi Jiang, Nian Liu, Song-Nan Li, Wei Wang, Xue-Yuan Guo, Xin Zhao, Song Zuo, Ri-Bo Tang, Chang-Sheng Ma","doi":"10.1111/pace.14571","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) and stable coronary artery disease (SCAD) frequently coexist. This study aimed to assess the long-term outcome of catheter ablation in patients with paroxysmal AF and SCAD.</p><p><strong>Methods: </strong>In total, 12,104 patients with paroxysmal AF underwent catheter ablation in the Chinese Atrial Fibrillation Registry between 2011 and 2019 were screened. A total of 441 patients with SCAD were matched with patients without SCAD in a 1:4 ratio. The primary endpoint was AF recurrence after single ablation. The composite secondary endpoints were thromboembolism, coronary events, major bleeding, all-cause death.</p><p><strong>Results: </strong>Over a mean follow-up of 46.0 ± 18.9 months, the recurrence rate in patients with SCAD was significantly higher after a single ablation (49.0% vs. 41.9%, p = .03). The very late recurrence rate of AF in the SCAD group was also significantly higher than that in the control group (38.9% vs. 31.2%;p = .04). In multivariate analysis, adjusted with the female, smoking, duration of AF, previous thromboembolism, COPD, and statins, SCAD was independently associated with AF recurrence (adjusted HR, 1.19 [1.02-1.40], p = .03). The composite secondary endpoints were significantly higher in the SCAD group (12.70% vs. 8.54%, p = .02), mainly due to thromboembolism events (8.16% vs. 4.41%, p < .01).</p><p><strong>Conclusions: </strong>SCAD significantly increased the risk of recurrence after catheter ablation of paroxysmal AF. The incidence of thromboembolic events after catheter ablation of paroxysmal AF in the patients with SCAD was significantly higher than that in those without SCAD.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1032-1041"},"PeriodicalIF":0.0000,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pacing and clinical electrophysiology : PACE","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1111/pace.14571","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/8/9 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 3
Abstract
Background: Atrial fibrillation (AF) and stable coronary artery disease (SCAD) frequently coexist. This study aimed to assess the long-term outcome of catheter ablation in patients with paroxysmal AF and SCAD.
Methods: In total, 12,104 patients with paroxysmal AF underwent catheter ablation in the Chinese Atrial Fibrillation Registry between 2011 and 2019 were screened. A total of 441 patients with SCAD were matched with patients without SCAD in a 1:4 ratio. The primary endpoint was AF recurrence after single ablation. The composite secondary endpoints were thromboembolism, coronary events, major bleeding, all-cause death.
Results: Over a mean follow-up of 46.0 ± 18.9 months, the recurrence rate in patients with SCAD was significantly higher after a single ablation (49.0% vs. 41.9%, p = .03). The very late recurrence rate of AF in the SCAD group was also significantly higher than that in the control group (38.9% vs. 31.2%;p = .04). In multivariate analysis, adjusted with the female, smoking, duration of AF, previous thromboembolism, COPD, and statins, SCAD was independently associated with AF recurrence (adjusted HR, 1.19 [1.02-1.40], p = .03). The composite secondary endpoints were significantly higher in the SCAD group (12.70% vs. 8.54%, p = .02), mainly due to thromboembolism events (8.16% vs. 4.41%, p < .01).
Conclusions: SCAD significantly increased the risk of recurrence after catheter ablation of paroxysmal AF. The incidence of thromboembolic events after catheter ablation of paroxysmal AF in the patients with SCAD was significantly higher than that in those without SCAD.
背景:心房颤动(AF)和稳定型冠状动脉疾病(SCAD)经常共存。本研究旨在评估阵发性房颤和SCAD患者导管消融的长期预后。方法:筛选2011年至2019年中国房颤登记中心的12104例阵发性房颤导管消融患者。共有441例SCAD患者与非SCAD患者按1:4的比例配对。主要终点为单次消融后房颤复发。复合次要终点为血栓栓塞、冠状动脉事件、大出血、全因死亡。结果:在平均46.0±18.9个月的随访中,单次消融后SCAD患者的复发率明显较高(49.0% vs 41.9%, p = 0.03)。SCAD组AF的极晚期复发率也显著高于对照组(38.9% vs. 31.2%;p = 0.04)。在多因素分析中,经女性、吸烟、房颤病程、既往血栓栓塞、COPD和他汀类药物校正后,SCAD与房颤复发独立相关(校正后HR为1.19 [1.02-1.40],p = 0.03)。SCAD组的复合次要终点明显较高(12.70% vs. 8.54%, p = 0.02),主要原因是血栓栓塞事件(8.16% vs. 4.41%), p结论:SCAD显著增加了阵发性房颤导管消融后复发的风险,SCAD患者阵发性房颤导管消融后血栓栓塞事件的发生率显著高于无SCAD患者。