Long-Term Outcomes After Catheter Ablation: A 42-Month Longitudinal Study From the ITHACA-Database

Area of Science:

• Cardiology
• Electrophysiology
• Medical Outcomes

Background:

• Limited real-world data exists on long-term clinical outcomes following catheter ablation (CA) for atrial fibrillation (AF).
• Assessing long-term results is crucial for understanding the durability of CA in managing AF.

Purpose of the Study:

• To evaluate the long-term effectiveness and outcomes of catheter ablation (CA) for atrial fibrillation (AF) within a large, multicenter health system.
• To identify predictors of success and recurrence rates after CA for AF.

Main Methods:

• A retrospective analysis of 3,440 patients undergoing de novo CA for AF between 2015 and 2021 was conducted.
• The primary outcome was freedom from AF, defined by specific electrocardiographic criteria, absence of cardioversion, and no repeat ablation.
• Longitudinal follow-up data was collected with 97% patient retention.

Main Results:

• The primary composite outcome (freedom from AF) was achieved in 52% of patients at the final follow-up (mean 42 months).
• While initial success rates differed between paroxysmal and persistent AF, annual recurrence rates were similar after the first year.
• Patients maintaining sinus rhythm for one year post-ablation had significantly higher long-term freedom from AF (80% vs. 48%).

Conclusions:

• Annual recurrence rates for atrial fibrillation (AF) after catheter ablation (CA) appear consistent across AF types beyond the first year.
• Achieving and maintaining sinus rhythm for one year following initial CA is a strong predictor of long-term success.
• These findings highlight the importance of sustained rhythm control post-ablation for durable AF management.