Higher baseline cardiorespiratory fitness is associated with lower arrhythmia recurrence and death after atrial fibrillation ablation.
Atrial fibrillation
Cardiorespiratory fitness
Catheter ablation
Exercise stress testing
Risk factor modification
Journal
Heart rhythm
ISSN: 1556-3871
Titre abrégé: Heart Rhythm
Pays: United States
ID NLM: 101200317
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
08
04
2020
revised:
30
04
2020
accepted:
04
05
2020
pubmed:
9
8
2020
medline:
15
9
2021
entrez:
9
8
2020
Statut:
ppublish
Résumé
Cardiorespiratory fitness (CRF) has been shown to correlate with incident atrial fibrillation (AF) and AF burden. In recent years there has been increasing recognition of the pivotal role of modifying risk factors before AF ablation. The purpose of this study was to investigate whether higher baseline CRF measured using exercise stress testing (EST) was associated with improved outcomes after AF ablation. We studied 591 patients who underwent EST within 12 months before AF ablation. Patients were categorized into low (<85% predicted), adequate (85%-100% predicted), and high (>100% predicted) CRF groups. Outcomes of interest included arrhythmia recurrence, cessation of antiarrhythmic therapy, repeat hospitalization for arrhythmia, repeat rhythm control procedures, and all-cause mortality. During mean follow-up of 32 months after ablation, arrhythmia recurrence was observed in 79% of patients in the low CRF group compared to 54% in the adequate CRF group and 27.5% in the high CRF group (P <.0001). Similarly, rates of repeat arrhythmia-related hospitalization, repeat rhythm control procedures, and need for ongoing antiarrhythmic therapy were significantly lower in the high CRF group (P <.0001). Death occurred in 2.5% of patients in the high CRF group compared to 4% in the adequate CRF group and 11% in the low CRF group (P <.0001). In Cox proportional hazards analyses, high CRF was significantly associated with lower arrhythmia recurrence. Higher CRF is associated with reduced arrhythmia recurrence rates and death among patients undergoing AF ablation. Efforts should be made to enhance CRF before AF ablation.
Sections du résumé
BACKGROUND
Cardiorespiratory fitness (CRF) has been shown to correlate with incident atrial fibrillation (AF) and AF burden. In recent years there has been increasing recognition of the pivotal role of modifying risk factors before AF ablation.
OBJECTIVE
The purpose of this study was to investigate whether higher baseline CRF measured using exercise stress testing (EST) was associated with improved outcomes after AF ablation.
METHODS
We studied 591 patients who underwent EST within 12 months before AF ablation. Patients were categorized into low (<85% predicted), adequate (85%-100% predicted), and high (>100% predicted) CRF groups. Outcomes of interest included arrhythmia recurrence, cessation of antiarrhythmic therapy, repeat hospitalization for arrhythmia, repeat rhythm control procedures, and all-cause mortality.
RESULTS
During mean follow-up of 32 months after ablation, arrhythmia recurrence was observed in 79% of patients in the low CRF group compared to 54% in the adequate CRF group and 27.5% in the high CRF group (P <.0001). Similarly, rates of repeat arrhythmia-related hospitalization, repeat rhythm control procedures, and need for ongoing antiarrhythmic therapy were significantly lower in the high CRF group (P <.0001). Death occurred in 2.5% of patients in the high CRF group compared to 4% in the adequate CRF group and 11% in the low CRF group (P <.0001). In Cox proportional hazards analyses, high CRF was significantly associated with lower arrhythmia recurrence.
CONCLUSION
Higher CRF is associated with reduced arrhythmia recurrence rates and death among patients undergoing AF ablation. Efforts should be made to enhance CRF before AF ablation.
Identifiants
pubmed: 32762978
pii: S1547-5271(20)30434-3
doi: 10.1016/j.hrthm.2020.05.013
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1687-1693Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.