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Impact of Sinus Rhythm Maintenance on Major Adverse Cardiac and Cerebrovascular Events after Catheter Ablation of Atrial Fibrillation: Insights from AF Frontier Ablation Registry
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  • Keisuke Usuda,
  • Takeshi Kato,
  • Toyonobu Tsuda,
  • Hayato Tada,
  • Satoru Niwa,
  • Soichiro Usui,
  • Kenji Sakata,
  • Kenshi Hayashi,
  • Hiroshi Furusho,
  • Masa-aki Kawashiri,
  • Masayuki Takamura,
  • Takayuki Otsuka,
  • Akio Hirata,
  • Masato Murakami,
  • Mitsuru Takami,
  • Masaomi Kimura,
  • Hidehira Fukaya,
  • Shiro Nakahara,
  • Wataru Shimizu,
  • Tomoo Harada,
  • Ken Okumura,
  • Teiichi Yamane,
  • Yukihiko Momiyama,
  • Kyoko Soejima,
  • Nobuhisa Hagiwara,
  • Masahide Harada,
  • Kazumasa Sonoda,
  • Masaru Inoue,
  • Koji Kumagai,
  • Hidemori Hayashi,
  • Kazuhiro Satomi,
  • Yuji Watari,
  • Naoya Matsumoto,
  • Koichi Nagashima,
  • Yasuo Okumura
Keisuke Usuda
Kanazawa University Graduate School of Medical Sciences

Corresponding Author:1220k.usuda@gmail.com

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Takeshi Kato
Kanazawa University Graduate School of Medical Sciences
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Toyonobu Tsuda
Kanazawa University Graduate School of Medical Sciences
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Hayato Tada
Kanazawa University Graduate School of Medical Sciences
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Satoru Niwa
Kanazawa University Graduate School of Medical Sciences
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Soichiro Usui
Kanazawa University Graduate School of Medical Sciences
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Kenji Sakata
Kanazawa University Graduate School of Medical Sciences
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Kenshi Hayashi
Kanazawa University Graduate School of Medical Sciences
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Hiroshi Furusho
Kanazawa University Graduate School of Medical Sciences
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Masa-aki Kawashiri
Kanazawa University Graduate School of Medical Sciences
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Masayuki Takamura
Kanazawa University Graduate School of Medical Sciences
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Takayuki Otsuka
The Cardiovascular Institute
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Akio Hirata
Osaka Police Hospital
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Masato Murakami
Shonan Kamakura General Hospital
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Mitsuru Takami
Kobe University Graduate School of Medicine
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Masaomi Kimura
Hirosaki University Graduate School of Medicine
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Hidehira Fukaya
Kitasato University School of Medicine
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Shiro Nakahara
Dokkyo Medical University Koshigaya Hospital
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Wataru Shimizu
Nippon Medical School
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Tomoo Harada
Saint Marianna University School of Medicine
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Ken Okumura
Saiseikai Kumamoto Hospital Cardiovascular Center
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Teiichi Yamane
Jikei University School of Medicine
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Yukihiko Momiyama
National Hospital Organisation Tokyo Medical Center
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Kyoko Soejima
Kyorin University School of Medicine
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Nobuhisa Hagiwara
Tokyo Women's Medical University
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Masahide Harada
Fujita Health University Hospital
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Kazumasa Sonoda
Tokyo Rinkai Hospital
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Masaru Inoue
National Hospital Organization Kanazawa Medical Center
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Koji Kumagai
Tohoku Medical and Pharmaceutical University Wakabayashi Hospital
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Hidemori Hayashi
Juntendo University School of Medicine Graduate School of Medicine
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Kazuhiro Satomi
Tokyo Medical University
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Yuji Watari
Teikyo University Hospital
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Naoya Matsumoto
Nihon University Hospital
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Koichi Nagashima
Nihon University School of Medicine Graduate School of Medicine
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Yasuo Okumura
Nihon University School of Medicine Graduate School of Medicine
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Abstract

Introduction: The impact of catheter ablation for atrial fibrillation (AF) on cardiovascular events and mortality is controversial. We investigated the impact of sinus rhythm maintenance on major adverse cardiac and cerebrovascular events after AF ablation from a Japanese multicenter cohort of AF ablation. Methods and Results: We investigated 2737 consecutive patients (25.6% female, mean age 63.4 ± 10.3 years) who underwent a first catheter ablation for AF from the Atrial Fibrillation registry to Follow the long-teRm Outcomes and use of aNTIcoagulants aftER Ablation (AF Frontier Ablation Registry). The primary endpoint was a composite of stroke, transient ischemic attack, cardiovascular events, and all-cause death. During a mean follow-up of 25.2 months, 2070 (75.6%) patients were free from AF after catheter ablation, and the primary composite endpoint occurred in 122 (4.5%) patients. The AF nonrecurrence group had a significantly lower incidence of the primary endpoint (1.7 per 100 person-years) compared with the AF recurrence group (3.2 per 100 person-years; P = 0.001). The multivariate analysis revealed that freedom from AF (hazard ratio 0.57; 95% confidence interval 0.39–0.83; P = 0.003) was independently associated with the incidence of the composite event.¬¬ Conclusion: In the multicenter cohort of AF ablation, sinus rhythm maintenance after catheter ablation was independently associated with lower rates of major adverse cardiac and cerebrovascular events.
Feb 2022Published in Heart and Vessels volume 37 issue 2 on pages 327-336. 10.1007/s00380-021-01929-5