Frontiers in cardiovascular medicine · 2025
Incidence of atrial fibrillation and its association with long-term outcome in patients with an accessory pathway.
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von Olshausen Gesa, Schwieler Jonas, Bastani Hamid, Bourke Tara, Saluveer Ott, Drca Nikola, Paul-Nordin Astrid, Charitakis Emmanouil, Asaad Fahd, Saygi Serkan, Turkmen Yusuf, Svennberg Emma, Åkerström Finn, Jensen-Urstad Mats, Braunschweig Frieder
Аннотация
OBJECTIVE: This study aimed to examine the incidence of atrial fibrillation in patients with an accessory pathway (AP) and its association with transient ischemic attack (TIA)/stroke as well as mortality over long-term follow-up.
METHODS: A total of 1,302 consecutive patients who underwent first-time ablation AP between 2005 and 2018 were included from the Karolinska Ablation Registry and followed up through the National Patient Registry and Cause of Death Registry.
RESULTS: Patients were 41.7 ± 15.7 years old and 60.9% were men. New-onset or recurrence of atrial fibrillation occurred in 111 patients (8.5%) after a follow-up of up to 10 years (median 6.8 years; interquartile range 3.9-9.9 years). Multivariable analysis revealed that a history of atrial fibrillation, hyperlipidemia, a higher BMI, and older age were independently associated with new-onset or recurrence of atrial fibrillation during follow-up. All-cause mortality and TIA/stroke occurred in 35 patients (2.7%) and 28 patients (2.2%) after a follow-up of 10 years, respectively. Multivariable analysis revealed that the occurrence of atrial fibrillation during follow-up was independently associated with both outcomes.
CONCLUSION: In this large patient cohort with ablated APs, long-term follow-up revealed a high incidence of atrial fibrillation with 8.5%. Occurrence of atrial fibrillation during follow-up was independently associated with both all-cause mortality and TIA/stroke. Hence, closer monitoring for atrial fibrillation is advisable in patients with ablated APs, especially in those with a prior history of atrial fibrillation.
METHODS: A total of 1,302 consecutive patients who underwent first-time ablation AP between 2005 and 2018 were included from the Karolinska Ablation Registry and followed up through the National Patient Registry and Cause of Death Registry.
RESULTS: Patients were 41.7 ± 15.7 years old and 60.9% were men. New-onset or recurrence of atrial fibrillation occurred in 111 patients (8.5%) after a follow-up of up to 10 years (median 6.8 years; interquartile range 3.9-9.9 years). Multivariable analysis revealed that a history of atrial fibrillation, hyperlipidemia, a higher BMI, and older age were independently associated with new-onset or recurrence of atrial fibrillation during follow-up. All-cause mortality and TIA/stroke occurred in 35 patients (2.7%) and 28 patients (2.2%) after a follow-up of 10 years, respectively. Multivariable analysis revealed that the occurrence of atrial fibrillation during follow-up was independently associated with both outcomes.
CONCLUSION: In this large patient cohort with ablated APs, long-term follow-up revealed a high incidence of atrial fibrillation with 8.5%. Occurrence of atrial fibrillation during follow-up was independently associated with both all-cause mortality and TIA/stroke. Hence, closer monitoring for atrial fibrillation is advisable in patients with ablated APs, especially in those with a prior history of atrial fibrillation.