Atrial fibrillation and the risk of ischaemic strokes or intracranial haemorrhages: Comparisons of the catheter ablation, medical therapy, and non-atrial fibrillation population

Min Kim, Hee Tae Yu, Jong Youn Kim, Tae Hoon Kim, Jae Sun Uhm, Boyoung Joung, Moon Hyoung Lee, Hui Nam Pak

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Aims: Although atrial fibrillation (AF) catheter ablation (AFCA) is an effective rhythm control strategy, there is limited data on whether ischaemic stroke (IS) or intracranial haemorrhage (ICH) decreases after AFCA compared with medical therapy or non-AF population. We explored the IS and ICH risk after AFCA or medical therapy in the AF population and matched non-AF population. Methods and results: We compared 1629 patients with AFCA (Yonsei AF ablation cohort), 3258 with medical therapy [Korean National Health Insurance (NHIS) database], and 3258 non-AF subjects (NHIS database) following a 1:2:2 propensity score matching. All AFCA patients underwent regular rhythm follow-ups for 51 ± 29 months. Among the AFCA group, the incidence rate ratio (IRR) of ISs was significantly higher in patients with sustained AF recurrences after the last ablation (0.87%) than in those remaining in sinus rhythm (0.24%, P = 0.017; log rank P = 0.003). The IRR of ISs was significantly higher in the medical therapy (1.09%) than AFCA (0.30%, P < 0.001, log rank P < 0.001 vs. medical therapy) or non-AF groups (0.34%, P < 0.001, log rank P < 0.001 vs. medical therapy; P = 0.673, log rank P = 0.874 vs. AFCA). The IRR of ICHs was 0.17% in the medical therapy, 0.06% in the AFCA (P = 0.023, log rank P = 0.042 vs. medical therapy), and 0.12% in the non-AF group (P = 0.226, log rank P = 0.241 vs. medical therapy; P = 0.172, log rank P = 0.193 vs. AFCA). Conclusion: Post-procedural AF control influences the risk of ISs. Atrial fibrillation catheter ablation significantly reduces the risk of both ISs and ICHs to the extent of the non-AF population compared to the medical therapy.

Original languageEnglish
Pages (from-to)529-538
Number of pages10
JournalEuropace
Volume23
Issue number4
DOIs
Publication statusPublished - 2021 Apr

Bibliographical note

Publisher Copyright:
© 2020 Published on behalf of the European Society of Cardiology. All rights reserved.

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint

Dive into the research topics of 'Atrial fibrillation and the risk of ischaemic strokes or intracranial haemorrhages: Comparisons of the catheter ablation, medical therapy, and non-atrial fibrillation population'. Together they form a unique fingerprint.

Cite this