Ablation Reduces Risk of Recurrent Stroke in Atrial Fibrillation

HealthDay News — For patients with atrial fibrillation (AF) and prior cerebrovascular accident (CVA), ablation is associated with reduced risk of recurrent stroke, according to a study published online in the Journal of Cardiovascular Electrophysiology.

Thomas Jared Bunch, MD, from the Intermountain Medical Center in Murray, Utah, and colleagues examined outcomes for AF ablation patients receiving their first ablation (139 patients), AF patients who did not receive ablation (416 patients), and CVA patients without clinical AF (416 patients). Patients had prior CVA, as determined by medical chart review, and 5 years of follow-up.

The researchers found that patients with AF ablation had higher rates of hypertension and heart failure (P <.0001), but the prevalence of diabetes was similar between the groups (P =.5). The AF, no ablation group had higher 5-year risk of CVA (hazard ratio [HR], 2.26; P <.0001) and death (HR, 2.43; P <.0001) than the ablated group. The 5-year risk for CVA (HR, 0.82; P =.39) and death (HR, 0.92; P =.70) did not differ significantly when comparing AF patients with ablation to patients without AF; however, the risk of heart failure was increased (HR, 3.08; P =.001).

“In patients with AF and a prior CVA, patients undergoing ablation have lower rates of recurrent stroke compared to AF patients not ablated,” the authors write.

Several authors disclosed financial ties to the pharmaceutical and medical technology industries.

Reference

Bunch TJ, May HT, Bair TL, et al. Five-year impact of catheter ablation for atrial fibrillation in patients with a prior history of stroke [published online November 13, 2017]. J Cardiovasc Electrophysiol. doi:10.1111/jce.13390