Matched comparison of catheter ablation versus conservative management for atrial fibrillation View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2022-02-06

AUTHORS

Tetsuma Kawaji, Satoshi Shizuta, Kyohei Yamaji, Munekazu Tanaka, Kazuki Kitano, Takanori Aizawa, Shintaro Yamagami, Akihiro Komasa, Takashi Yoshizawa, Masashi Kato, Takafumi Yokomatsu, Shinji Miki, Koh Ono, Takeshi Morimoto, Takeshi Kimura

ABSTRACT

It is still controversial whether catheter ablation for atrial fibrillation (AF) could improve clinical outcomes in general AF population. Among 4398 patients with diagnosis of AF in the outpatient department of Kyoto University Hospital between January 2005 and March 2015, we identified 537 pairs of patients who received first-time catheter ablation (ablation group) or conservative management (conservative group), matched for age, gender, AF duration, AF type, AF symptoms, and previous heart failure (HF). The primary outcome measure was a composite of cardiovascular death, HF hospitalization, ischemic stroke, or major bleeding. Most baseline characteristics were well balanced between the 2 groups, except for the higher prevalence of low body weight, history of malignancy, and severe chronic kidney disease in the conservative group. Median follow-up duration was 5.3 years. The cumulative 5-year incidence of the primary outcome measure was significantly lower in the ablation group than in the conservative group (5.2% versus 15.6%, log-rank P < 0.001). Even after adjusting for the imbalances in the baseline characteristics, the lower risk of the ablation group relative to the conservative group for the primary outcome measure remained highly significant (HR 0.32, 95% CI 0.21–0.47, P < 0.001). Ablation compared with conservative management was also associated with significantly lower risks for the individual components of the primary outcome. In this matched analysis in AF patients, ablation as compared with conservative management was associated with better long-term clinical outcomes, although we could not deny the possibility of selection bias and unmeasured confounding. More... »

PAGES

1242-1254

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00380-022-02023-0

DOI

http://dx.doi.org/10.1007/s00380-022-02023-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1145317513

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/35124705


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