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

D-PO03-174 - Reduction Of Mortality And Heart Failure Hospitalization By Catheter Ablation Of Atrial Fibrillation In Patients With Heart Failure: A Real World Analysis (ID 1139)

Disclosure
 B. Joung: Nothing relevant to disclose.

Abstract

Background: It is unclear whether catheter ablation for atrial fibrillation (AF) improves survival and affects other outcomes in real-world HF patients.
Objective: This study aimed to evaluate whether ablation reduces death, heart failure admission, acute myocardial infarction (MI), stroke and major bleeding in real-world AF patients with HF.
Methods: Among 801,710 patients with AF from 2006 to 2015 in the Korean National Health Insurance Service database, 3,709 HF patients underwent AF ablations. Inverse probability of treatment (IPT) weighting was used to construct ablation and no-ablation group.
Results: After IPT weighting, the 2 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 patients was a half of that in non-ablated patients ((1.7 and 4.4 per 100 person-years, hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.33-0.60, P<0.001). Ablation was related with lower incidence and risk of HF admission (1.5 and 2.7 per 100 person-years, HR 0.54, 95% CI 0.41-0.71, p<0.001) and acute myocardial infarction (0.2 and 0.5 per 100 person-years, HR 0.44, 95% CI 0.19-0.99, p<0.001). Ablation was associated with decreased risk of death in most subgroups except elderly (≥ 75 years) and high OAC rate (≥ 80%) patients, and risk of HF admission except elderly (≥ 75 years), diabetes and stroke/TIA patients. However, the risk of stroke and major bleeding was not changed after ablation.
Conclusion: Ablation may be associated with lower incidences of death, heart failure, and acute MI in real world AF patients with HF, supporting the role of AF ablation in HF.
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