title: Patients treated with catheter ablation for atrial fibrillation have long-term rates of death, stroke, and dementia similar to patients without atrial fibrillation.
abstract: BACKGROUND
  Atrial fibrillation (AF) adversely impacts mortality, stroke, heart failure, and dementia. AF ablation eliminates AF in most patients. We evaluated the long-term impact of AF ablation on mortality, heart failure (HF), stroke, and dementia in a large system-wide patient population.
  
  
  METHODS
  A total of 4,212 consecutive patients who underwent AF ablation were compared (1:4) to 16,848 age/gender matched controls with AF (no ablation) and 16,848 age/gender matched controls without AF. Patients were enrolled from the large ongoing prospective Intermountain AF study and were followed for at least 3 years.
  
  
  RESULTS
  Of the 37,908 patients, mean age 65.0 ± 13 years, 5,667 (14.9%) died, 1,296 (3.4%) had a stroke, and 1,096 (2.9%) were hospitalized for HF over >3 years of follow-up. AF ablation patients were less likely to have diabetes, but were more likely to have hypertension, HF, and significant valvular heart disease. AF ablation patients had a lower risk of death and stroke in comparison to AF patients without ablation. Alzheimer's dementia occurred in 0.2% of the AF ablation patients compared to 0.9% of the AF no ablation patients and 0.5% of the no AF patients (P < 0.0001). Other forms of dementia were also reduced significantly in those treated with ablation. Compared to patients with no AF, AF ablation patients had similar long-term rates of death, dementia, and stroke.
  
  
  CONCLUSIONS
  AF ablation patients have a significantly lower risk of death, stroke, and dementia in comparison to AF patients without ablation. AF ablation may eliminate the increased risk of death and stroke associated with AF.
authors.affiliation: Intermountain Heart Rhythm Specialists Department of Cardiology, Intermountain Medical Center, Murray, Utah 84107, USA. Thomas.bunch@imail.org
authors.forename: T Jared
authors.initials: TJ
authors.lastname: Bunch
authors.forename: Brian G
authors.initials: BG
authors.lastname: Crandall
authors.forename: J Peter
authors.initials: JP
authors.lastname: Weiss
authors.forename: Heidi T
authors.initials: HT
authors.lastname: May
authors.forename: Tami L
authors.initials: TL
authors.lastname: Bair
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Osborn
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Anderson
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Muhlestein
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Horne
authors.forename: Donald L
authors.initials: DL
authors.lastname: Lappe
authors.forename: John D
authors.initials: JD
authors.lastname: Day
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation / Q000401:mortality / Q000639:trends*; D015331:Cohort Studies; D003704:Dementia / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011446:Prospective Studies; D020521:Stroke / Q000401:mortality / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome