Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO03 - Poster Session III (ID 48) Poster

D-PO03-159 - Risks Of Ischemic Stroke And Intracranial Hemorrhage After Catheter Ablation Of Atrial Fibrillation (ID 1130)


Background: Although reduction of atrial fibrillation (AF) burden may reduce the risk of ischemic stroke (IS), whether AF catheter ablation (AFCA) is superior to medical therapy has not yet been evaluated.
Objective: We explored the risk of IS and intracranial hemorrhage (ICH) depending on medical therapy and AFCA.
Methods: Among 2,769 patients who underwent AF catheter ablation (AFCA) and 14,056 with AF under medical therapy in the National Health Insurance Service database, we compared 1,629 with AFCA (57±11 years old, 22.1% female) and 3,258 with medical therapy after 1:2 propensity-score matching. All included patients were followed up regularly and the antithrombotic therapies were evaluated.
Results: 1. During 51±29 months follow-up, the annual risks of IS were significantly lower in the AFCA group (0.31%) than in medical therapy group (1.11%, p<0.001, Log-rank p<0.001). 2. The annual risks of ICH were 0.05% in the AFCA group and 0.16% in the medical therapy group (p=0.052, Log-rank p=0.042), respectively. After multivariable adjustments, AFCA was independently associated with lower risk of IS (HR 0.26 [0.16-0.42], p<0.001) and ICH (HR 0.33 [0.12-0.97], p=0.044). 3. Among the patients who underwent AFCA, 127 patients (7.8%) remained in sustaining AF/ atrial tachycardia (AT) after the last ablation procedure and sustaining AF/AT was independently associated with IS (HR 4.88 [1.41-16.87], p=0.012).
Conclusion: AFCA significantly reduced the risks of IS and ICH compared to medical therapy in patients with AF. However, the risk of IS was pronounced in patients recurred as sustaining AF/AT even after AFCA.