Chronic but not Transient Anemia Is Associated With Atrial Fibrillation Recurrence After Catheter Ablation

Area of Science:

• Cardiology
• Hematology

Background:

• Anemia is a common comorbidity in patients diagnosed with atrial fibrillation (AF).
• Previous research linked pre-procedural anemia to increased AF recurrence post-catheter ablation.
• The distinct prognostic implications of chronic versus transient anemia remained undetermined.

Purpose of the Study:

• To investigate the association between chronic and transient anemia and the recurrence of AF after a first-time catheter ablation procedure.
• To differentiate the risks conferred by chronic anemia compared to transient anemia in the context of AF ablation outcomes.

Main Methods:

• A nationwide cohort study utilizing the Danish National Ablation Database.
• Inclusion of 15,017 patients undergoing their first AF ablation between 2010 and 2024.
• Categorization of anemia status (no anemia, transient, chronic) based on hemoglobin levels within 12 months pre-procedure and assessment of AF recurrence within 1 year post-ablation.

Main Results:

• Chronic anemia was present in 5.8% and transient anemia in 10.6% of patients.
• The 1-year AF recurrence rate was highest in chronic anemia (32.5%), followed by transient anemia (24.2%) and no anemia (23.0%).
• Chronic anemia independently predicted increased AF recurrence risk (aHR: 1.36; 95% CI: 1.18-1.56), while transient anemia did not (aHR: 0.98; 95% CI: 0.87-1.10).

Conclusions:

• Chronic anemia, identified before catheter ablation, is independently associated with a significantly higher risk of AF recurrence.
• Transient anemia, in contrast, did not show a significant association with AF recurrence post-ablation.
• These findings underscore the importance of assessing the chronicity of anemia in AF patients undergoing catheter ablation.