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Major adverse cardiovascular events and mortality after catheter ablation in Japanese patients with atrial fibrillation: The Fushimi AF Registry

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Abstract

Background

The impact of catheter ablation (CA) on the long-term clinical outcomes in atrial fibrillation (AF) are unclear due to limited cohort investigations.

Methods

The Fushimi AF Registry is a community-based prospective survey of patients with AF in Fushimi-ku, Kyoto, Japan. Of 4465 patients enrolled between March 2011 and July 2019, analyses were performed on 2639 patients (492 patients who underwent CA and 2147 patients who received standard rhythm- and/or rate-control drug therapy at baseline). We compared the baseline characteristics and the incidence of major adverse cardiovascular events (MACE: the composite of cardiovascular death, heart failure hospitalization, myocardial infarction, ischemic stroke or systemic embolism), and all-cause mortality during the follow-up using propensity score matching.

Results

After entering 20 covariates in the current matching analysis, 342 patients who underwent CA and 342 matched patients who received drug therapy, with a median follow-up of 1865 days, were included. The patients who underwent CA were significantly associated with lower incidence of MACE (hazard ratio (HR) 0.56, 95% confidential interval (CI) 0.36–0.86; P = 0.0077), and all-cause mortality (HR 0.47, 95% CI 0.29–0.75; P = 0.0016).

Conclusion

CA was associated with lower incidences of MACE and all-cause mortality for patients with AF as compared with those who received drug therapy. The most common event of MACE in patients who underwent CA was heart failure hospitalization.

Clinical trial registration

URL: http://www.umin.ac.jp/ctr/index.htm

Unique identifier

UMIN000005834.

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Acknowledgment

We sincerely appreciate the efforts of all of the institutions participating in the registry and the clinical research coordinators (T. Shinagawa, M. Mitamura, M. Fukahori, M. Kimura, M. Fukuyama, C. Kamata and N. Nishiyama).

Funding

The Fushimi AF Registry is supported by research funding from Boehringer Ingelheim, Bayer Healthcare, Pfizer, Bristol-Myers Squibb, Astellas Pharma, AstraZeneca, Daiichi Sankyo, Novartis Pharma, MSD, Sanofi-Aventis and Takeda Pharmaceutical. This research is partially supported by the Practical Research Project for Life-Style related Diseases including Cardiovascular Diseases and Diabetes Mellitus from Japan Agency for Medical Research and Development, AMED (19ek0210082h0003, 18ek0210056h0003).

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Authors and Affiliations

  1. Department of Cardiology, Heart Rhythm Section, Ogaki Tokushukai Hospital, 6-85-1, Hayashimachi, Ogaki, 503-0015, Japan

    Masahiro Esato

  2. Department of Cardiology, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto, 612-8555, Japan

    Yoshimori An, Hisashi Ogawa, Mitsuru Abe & Masaharu Akao

  3. Division of Translational Research, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto, 612-8555, Japan

    Hiromichi Wada & Koji Hasegawa

  4. Tsuji Clinic, 5-8, Kogahonmachi, Fushimi-ku, Kyoto, 612-8492, Japan

    Hikari Tsuji

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  1. Masahiro Esato
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Correspondence to Masaharu Akao.

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Conflict of interest

Dr Akao received lecture fees from Pfizer, Bristol-Myers Squibb, Boehringer Ingelheim, Bayer Healthcare, and Daiichi Sankyo. All other authors have reported that they have no relationships relevant to the content of this paper to disclose.

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Esato, M., An, Y., Ogawa, H. et al. Major adverse cardiovascular events and mortality after catheter ablation in Japanese patients with atrial fibrillation: The Fushimi AF Registry. Heart Vessels 36, 1219–1227 (2021). https://doi.org/10.1007/s00380-021-01796-0

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