BACKGROUND: A low incidence of thromboembolic events after successful catheter ablation of atrial fibrillation (AF) during a mid-term follow-up period was recently reported. However, because the incidence of such events over the long term is unknown, we investigated the late incidence of thromboembolic events after catheter ablation. METHODS AND RESULTS: Patients with paroxysmal and persistent AF undergoing catheter ablation and being followed up for at least 24 months formed the study group (n = 524); 82 patients (16%) had CHADS₂ scores of at least 2. Mean follow-up was 44 ± 13 months. Warfarin was discontinued in 400 (93%) of 429 patients (82% of 524 patients) without AF recurrence. None of the patients without AF recurrence suffered thromboembolic events, whereas 3 of 95 patients (3%) with AF recurrence did (P < 0.001). One of the 3 was a late AF recurrence occurring > 12 months after catheter ablation. There were 2 nonfatal major hemorrhagic events in patients with AF recurrence who continued on warfarin, but no hemorrhagic events were observed in patients free from AF (P = 0.002). CONCLUSIONS: Maintenance of sinus rhythm after catheter ablation of AF was associated with a lower incidence of thromboembolic events during long-term follow-up >3 years. This result suggests that catheter ablation reduces thromboembolic events if patients continue anticoagulation regardless of the ablation outcome.
BACKGROUND: A low incidence of thromboembolic events after successful catheter ablation of atrial fibrillation (AF) during a mid-term follow-up period was recently reported. However, because the incidence of such events over the long term is unknown, we investigated the late incidence of thromboembolic events after catheter ablation. METHODS AND RESULTS:Patients with paroxysmal and persistent AF undergoing catheter ablation and being followed up for at least 24 months formed the study group (n = 524); 82 patients (16%) had CHADS₂ scores of at least 2. Mean follow-up was 44 ± 13 months. Warfarin was discontinued in 400 (93%) of 429 patients (82% of 524 patients) without AF recurrence. None of the patients without AF recurrence suffered thromboembolic events, whereas 3 of 95 patients (3%) with AF recurrence did (P < 0.001). One of the 3 was a late AF recurrence occurring > 12 months after catheter ablation. There were 2 nonfatal major hemorrhagic events in patients with AF recurrence who continued on warfarin, but no hemorrhagic events were observed in patients free from AF (P = 0.002). CONCLUSIONS: Maintenance of sinus rhythm after catheter ablation of AF was associated with a lower incidence of thromboembolic events during long-term follow-up >3 years. This result suggests that catheter ablation reduces thromboembolic events if patients continue anticoagulation regardless of the ablation outcome.
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: Heart Rhythm Date: 2017-05-12 Impact factor: 6.343
Authors: Hugh Calkins; Karl Heinz Kuck; Riccardo Cappato; Josep Brugada; A John Camm; Shih-Ann Chen; Harry J G Crijns; Ralph J Damiano; D Wyn Davies; John DiMarco; James Edgerton; Kenneth Ellenbogen; Michael D Ezekowitz; David E Haines; Michel Haissaguerre; Gerhard Hindricks; Yoshito Iesaka; Warren Jackman; José Jalife; Pierre Jais; Jonathan Kalman; David Keane; Young-Hoon Kim; Paulus Kirchhof; George Klein; Hans Kottkamp; Koichiro Kumagai; Bruce D Lindsay; Moussa Mansour; Francis E Marchlinski; Patrick M McCarthy; J Lluis Mont; Fred Morady; Koonlawee Nademanee; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Douglas L Packer; Carlo Pappone; Eric Prystowsky; Antonio Raviele; Vivek Reddy; Jeremy N Ruskin; Richard J Shemin; Hsuan-Ming Tsao; David Wilber Journal: Heart Rhythm Date: 2012-03-01 Impact factor: 6.343
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: Europace Date: 2018-01-01 Impact factor: 5.214