Characteristics and Occupational Trends of Military Tactical Athletes with Repeat Atrial Fibrillation Catheter...

Atrial fibrillation (AF) catheter ablation can provide safe and effective endpoints for active duty (AD) military personnel. There are limited reports describing characteristics of AD military personnel with AF requiring repeat catheter ablation. This study aims to compare characteristics and dispositions of AD military members who received single versus repeat AF catheter ablation.

AD military personnel with AF diagnoses who underwent single and repeated AF catheter ablations between 2004 and 2019 were compared.

We retrospectively analyzed a cohort of 386 military personnel with symptomatic AF, of which 104 underwent catheter ablation. Twenty-seven of 104 (26%) personnel received repeat AF catheter ablations on average 16.1 ± 31 months after first ablation because of AF recurrences (100% vs. 29%, P ≤ .0001). Between those who received a single versus repeated AF ablation, there were no differences between age (34.5 ± 9.5 vs. 37.6 ± 9.8 years, P = .13), BMI (28.1 ± 3.9 vs. 28.7 ± 3.4 kg/m2, P = .46), presence of diastolic dysfunction (11.7% vs. 7.4%, P = .53), left atrial appendage emptying velocities (58.4 ± 22 vs. 59.7 ± 23 cm/s, P = .82), left atrial volume index (29.4 ± 9.9 vs. 29.6 ± 8.8 mL/m2, P = .87), left ventricular ejection fraction (60.4 ± 6% vs. 58.5 ± 13%, P = .31), and CHA2DS2-VASc scores (0.377 ± 0.6 vs. 0.444 ± 0.7, P = .60). Aviators (4/10, 40%) and healthcare workers (12/34, 35%) underwent more repeated catheter ablations relative to industrial workers 2/22 (10%), respectively (P = .0012 and P = .027; Figure 2). Rates of military retention and deployment among all with AF (N = 386, 68%, 40%), single ablation (N = 77, 78%, 43%), and repeat ablation (N = 27, 70%, 37%) were similar.

Repeat AF catheter ablation rates in military personnel may be driven by individual occupational requirements in the setting of AF recurrences without increased established risk factors for AF recurrence. This study suggests certain military occupation groups may seek elective repeated ablation strategies at higher percentages irrespective of AF recurrence. Repeat catheter ablation demonstrated a trend in preserving military retention and continued deployment rates.