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Optimal timing for atrial fibrillation patients to undergo catheter ablation

Mingjie Lin1,2, Huan Liang1,2, Kai Zhang1

  • 1State Key Laboratory for Innovation and Transformation of Luobing Theory; Key Laboratory of Cardiovascular Remodeling and Function Research of Chinese Ministry of Education, Chinese National Health Commission, Chinese Academy of Medical Sciences and Shandong Province; Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China.

Communications Medicine
|June 21, 2025
PubMed

Insights

Early catheter ablation for atrial fibrillation (AF) is recommended, especially for persistent AF, as delayed treatment increases recurrence risk. However, the timing of ablation does not impact major adverse cardiovascular events.

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • The optimal timing for catheter ablation in atrial fibrillation (AF) patients is unclear.
  • Investigating the relationship between diagnosis-to-ablation time (DAT) and patient outcomes is crucial.

Purpose of the Study:

  • To evaluate the impact of diagnosis-to-ablation time (DAT) on AF recurrence.
  • To assess the effect of DAT on major adverse cardiovascular and cerebrovascular events (MACCE) after catheter ablation.

Main Methods:

  • Prospective observational study of 2097 patients undergoing AF ablation (2016-2020).
  • Patients stratified into three DAT groups: ≤1 year, >1 to ≤3 years, and >3 years.
  • Cox regression and logistic regression analyses identified predictors of AF recurrence and MACCE.

Main Results:

  • Longer DAT was significantly associated with increased AF recurrence (HR 1.003 per month), particularly in persistent AF.
  • Left atrial diameter ≥40mm and female sex were independent predictors of AF recurrence.
  • DAT did not significantly impact MACCE; age and vascular disease were independent predictors.

Conclusions:

  • Early catheter ablation is advisable for maintaining sinus rhythm, especially in persistent AF patients.
  • Diagnosis-to-ablation time does not influence the occurrence of MACCE.
  • Findings support a shift towards earlier ablation strategies for AF management.
Abstract

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