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

D-PO03-160 - Catheter Ablation Improve Outcome In Frail Patients With Atrial Fibrillation: A Real World Analysis (ID 1131)


Background: It is unclear whether catheter ablation improves survival and affects other outcomes in frail patients with atrial fibrillation (AF).
Objective: This study aimed to evaluate whether ablation reduces death, heart failure admission, acute myocardial infarction, and stroke in real-world AF patients with frail risk.
Methods: In 801,710 patients with AF from 2006 to 2015 in the Korean National Health Insurance Service database, 1,411 frail patients underwent AF ablations. Frail patients was defined as patients with intermediate or high Hospital Frailty Risk categories. Inverse probability of treatment (IPT) weighting was used to construct frail ablation and no-ablation group.
Results: After IPT weighting, the two cohorts had similar background characteristics. During a median follow-up of 5.0 (IQR 2.8-9.0) years, the risk of death in ablated frail patients was reduced by 65% than in non-ablated frail patients (2.0 and 6.4 per 100 person-years, hazard ratio [HR] 0.35, 95% confidence interval [CI] 0.25-0.50, P<0.001). Ablation was related with lower incidence and risk of heart failure admission (1.8 and 3.1 per 100 person-years, HR 0.66, 95% CI 0.44-0.98, p=0.042) and acute myocardial infarction (0.2 and 0.6 per 100 person-years, HR 0.30, 95% CI 0.15-0.62, p=0.001). Ablation was associated with decreased risk of death in most subgroups except in patients with anticoagulation adherence (proportion of days covered ≥ 80%). However, the risk of stroke and major bleeding was not changed after ablation.
Conclusion: Ablation was associated with lower risk of death, heart failure, and acute MI in real world AF patients with frailty, supporting the role of AF ablation in these patients.