title: Successful catheter ablation reduces the risk of cardiovascular events in atrial fibrillation patients with CHA2DS2-VASc risk score of 1 and higher.
abstract: OBJECTIVE
  It is not known if successful catheter ablation for atrial fibrillation (AF) improves the patient's long-term cardiovascular outcomes. This study investigated the long-term outcomes and mortality of AF patients at high risk who received antiarrhythmic medication and catheter ablation.
  
  
  RESULTS
  The propensity scores for AF were calculated for each patient and were used to assemble a cohort of 174 AF patients with ablation who were compared with an equal number of AF patients without ablation. Composite cardiovascular end points (major adverse cardiovascular event, MACE), including mortality and vascular events in the medically treated patients representing the control group (group 1), were compared with those in the ablation-treated patients (group 2). The rates of the total mortality (2.95% vs. 0.74% per year; P < 0.01), cardiovascular death (1.77% vs. 0% per year; P = 0.001), and ischaemic stroke/transient ischaemic attack (2.21% vs. 0.59% per year; P = 0.02) were higher in group 1 than group 2, respectively. A multivariate Cox regression analysis of the MACE scores showed that a higher CHA2DS2-VASc score [hazard ratio (HR) = 1.309 per increment of score, 95% confidence interval (CI) = 1.06-1.617; P = 0.01] and the performance of the ablation procedure (HR = 0.225, CI = 0.076-0.671; P = 0.007) were independent predictors of a MACE. In patients who received catheter ablation, recurrence of any atrial arrhythmia was a predictor of vascular events and total mortality (P < 0.05).
  
  
  CONCLUSIONS
  In AF patients with CHA2DS2-VASc score ≥1, catheter ablation of AF reduced the risk of the total/cardiovascular mortality and total vascular events. Atrial fibrillation recurrence predicts long-term cardiovascular outcomes, as well as the CHA2DS2-VASc score.
authors.affiliation: Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Sec. 2 Shih-Pai Road, Taipei, Taiwan.
authors.forename: Yenn-Jiang
authors.initials: YJ
authors.lastname: Lin
authors.forename: Tze-Fan
authors.initials: TF
authors.lastname: Chao
authors.forename: Hsuan-Ming
authors.initials: HM
authors.lastname: Tsao
authors.forename: Shih-Lin
authors.initials: SL
authors.lastname: Chang
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Lo
authors.forename: Chern-En
authors.initials: CE
authors.lastname: Chiang
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Hu
authors.forename: Pai-Feng
authors.initials: PF
authors.lastname: Hsu
authors.forename: Shao-Yuan
authors.initials: SY
authors.lastname: Chuang
authors.forename: Cheng-Hung
authors.initials: CH
authors.lastname: Li
authors.forename: Fa-Po
authors.initials: FP
authors.lastname: Chung
authors.forename: Yun-Yu
authors.initials: YY
authors.lastname: Chen
authors.forename: Tsu-Juey
authors.initials: TJ
authors.lastname: Wu
authors.forename: Ming-Hsiung
authors.initials: MH
authors.lastname: Hsieh
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000401:mortality* / Q000628:therapy*; D002318:Cardiovascular Diseases / Q000401:mortality*; D017115:Catheter Ablation / Q000401:mortality*; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000401:mortality; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries / Q000706:statistics & numerical data*; D018570:Risk Assessment; D020521:Stroke / Q000401:mortality* / Q000517:prevention & control; D016019:Survival Analysis; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents