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Diagnosis-to-Ablation Time and Atrial Arrhythmia Recurrence After Ablation
Matthew J Singleton1, Christopher Thorne2, Chang Dai3
1Department of Cardiovascular Medicine, WellSpan Health, York, Pennsylvania.
JAMA Network Open
|July 14, 2026
Summary
Longer diagnosis-to-ablation time (DAT) increases the risk of atrial arrhythmia recurrence after radiofrequency ablation (RFA) for atrial fibrillation (AF). Delayed referral for RFA may be a key prognostic indicator.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Informatics
Background:
- Diagnosis-to-ablation time (DAT) is a potential predictor of ablation outcomes in atrial fibrillation (AF).
- Limited evidence exists on the impact of prolonged DAT due to small sample sizes and methodological inconsistencies in prior studies.
Purpose of the Study:
- To investigate the association between DAT and the recurrence of atrial arrhythmias after radiofrequency ablation (RFA) for AF.
Main Methods:
- A cohort study included 3724 patients undergoing de novo RFA for AF from January 2018 to June 2023.
- Multivariable Cox regression analysis assessed the relationship between DAT and 1-year postablation atrial arrhythmia recurrence.
Main Results:
- Patients with DAT of 1-4 years had a 48% higher risk of recurrence compared to those with DAT <1 year (HR, 1.48; P=.01).
- Patients with DAT >5 years faced a 110% increased risk of recurrence (HR, 2.10; P<.001).
- The median DAT was 1 year, with 64.8% of patients having paroxysmal AF.
Conclusions:
- Prolonged DAT is significantly associated with an increased risk of atrial arrhythmia recurrence within one year post-RFA.
- Delayed referral for AF ablation may serve as a crucial prognostic marker in current clinical practice.
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