Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-127 - The Clinical And Genetic Relationship Between Anemia And Atrial Fibrillation Recurrence After Catheter Ablation (ID 1204)

 M. Kim: Nothing relevant to disclose.


Background: Anemia is a known adverse prognostic factor among patients with cardiovascular diseases. However, no study has evaluated the direct link between anemia and the rhythm control outcome of AF.
Objective: We investigated whether the hemoglobin level was associated with the rhythm outcome after atrial fibrillation (AF) catheter ablation (AFCA).
Methods: We included 2627 patients who underwent AFCA and a guidelines-based rhythm follow-up (age 58±10.9 years, 73% men, 30.6% with persistent AF), and evaluated the association of pre-AFCA anemia (hemoglobin <13 g/dL in men and <12 g/dL in women) and rhythm outcomes. We studied the mechanistic relationship between anemia and AF recurrence using a Mendelian randomization analysis (1775 subjects) after reviewing already proven 12 hemoglobin-associated genetic polymorphisms.
Results: The body mass index, paroxysmal AF, warfarin use, and baseline red cell distribution width were independently associated with anemia in patients with AF. During a 23 month follow-up (interval OR 9-48 months), the clinical AF recurrence rate was significantly higher in patients with than without anemia (log-rank p=0.001; propensity score-matched log-rank p=0.004). This pattern was more significant in male patients (Log-rank p<0.001) or patients with paroxysmal AF (Log-rank p<0.001). Anemia (hazard ratio [HR] 1.45 [1.17-1.80], p=0.001), the left atrial diameter (HR 1.03 [1.01-1.04], p=0.001), and persistent AF (HR 1.58 [1.36-1.84], p<0.001) were independently associated with post-AFCA clinical recurrence. In the Mendelian randomization, we could not find a significant direct causal relationship between anemia and AF recurrence at the genetic level.
Conclusion: Pre-AFCA anemia is an independent predictor of post-AFCA clinical recurrence, especially in male patients, without a genetically direct causal relationship.