Prevalence and Impact of Poorly Controlled Modifiable Risk Factors Among Patients Who Underwent Atrial Fibrillation Ablation
Section snippets
Methods
Medical records and procedure notes were retrospectively reviewed for consecutive patients who underwent AF ablation at the University of Nebraska Medical Center in Omaha, Nebraska between 2012 and 2019. All patients were aged ≥19 years and had at least 1 cardiac monitor after a 3-month blanking period. This work was approved by the University of Nebraska Medical Center Institutional Review Board under protocols 0054-22-EP and 0576-20-EP.
Baseline characteristics, CHA2DS2-VASc score (congestive
Results
The preablation baseline characteristics of the 724 patients are listed in Table 1. The mean age at the index ablation was 61.9 ± 10.3 years and 32.5% were women. Most of the study patients had persistent AF (72.2%) and 18.1% had undergone a previous catheter ablation. The mean baseline CHA2DS2VASc score was 2.4 ± 1.6. Common co-morbidities included hypertension (63.4% of participants), congestive heart failure (33.4%), diabetes mellitus (18.1%), and previous cardiovascular accidents (7.2%).
Discussion
In this retrospective study from a tertiary care center, we observed that poorly controlled modifiable RFs were highly prevalent among patients with AF referred for catheter ablation. Uncontrolled or untreated RFs, specifically a fluctuation in BMI >5%, diabetes mellitus with hemoglobin A1c ≥6.5%, and uncontrolled hyperlipidemia were associated with a 1.3 to 1.5 times increased risk of recurrent AF, cardiovascular admissions, or cardiovascular death. In addition, excessive alcohol use was
Acknowledgment
The authors thank James Aguto, BS, for his assistance with data collection.
Disclosures
The remaining authors have no conflicts of interest to declare. Drs. Stout and Naksuk take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
References (45)
- et al.
Long-term effect of goal-directed weight management in an atrial fibrillation cohort: A long-term follow-up study (LEGACY)
J Am Coll Cardiol
(2015) - et al.
Aggressive risk factor reduction study for atrial fibrillation and implications for the outcome of ablation: the ARREST-AF cohort study
J Am Coll Cardiol
(2014) - et al.
Age-related differences in presentation, treatment, and outcome of patients with atrial fibrillation in Europe: the EORP-AF General Pilot registry (EURObservational Research Programme-atrial Fibrillation)
JACC Clin Electrophysiol
(2015) - et al.
Achievement and quality measure attainment in patients hospitalized with atrial fibrillation: results from the Get with the Guidelines - Atrial Fibrillation (GWTG-AFIB) registry
Am Heart J
(2022) - et al.
Rhythm or rate control in atrial fibrillation–Pharmacological Intervention in Atrial Fibrillation (PIAF): a randomised trial
Lancet
(2000) - et al.
Mechanisms of long-term recurrence 3 years after catheter ablation of atrial fibrillation
JACC Clin Electrophysiol
(2020) - et al.
A U-shaped relationship of body mass index on atrial fibrillation recurrence post ablation: A report from the Guangzhou atrial fibrillation ablation registry
EBioMedicine
(2018) - et al.
Association between pre-ablation glycemic control and outcomes among patients with diabetes undergoing atrial fibrillation ablation
JACC Clin Electrophysiol
(2019) - et al.
Obesity and the risk of incident, post-operative, and post-ablation atrial fibrillation: a meta-analysis of 626,603 individuals in 51 studies
JACC Clin Electrophysiol
(2015) - et al.
Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study
Circulation
(2014)
Estimation of total incremental health care costs in patients with atrial fibrillation in the United States
Circ Cardiovasc Qual Outcomes
Long-term outcomes of catheter ablation of atrial fibrillation: a systematic review and meta-analysis
J Am Heart Assoc
Long-term outcome of catheter ablation in atrial fibrillation patients with coexistent metabolic syndrome and obstructive sleep apnea: impact of repeat procedures versus lifestyle changes
J Cardiovasc Electrophysiol
Diagnosis-to-ablation time and recurrence of atrial fibrillation following catheter ablation: A systematic review and meta-analysis of observational studies
Circ Arrhythm Electrophysiol
Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging [published correction appears in Eur Heart J Cardiovasc Imaging 2016;17:412] [published correction appears in Eur Heart J Cardiovasc Imaging 2016;17:969]
Eur Heart J Cardiovasc Imaging
Dietary guidelines for Americans, 2020–2025: understanding the scientific process, guidelines, and key recommendations
Nutr Today
Cohort profile: the ESC EURObservational Research Programme Atrial Fibrillation III (AF III) Registry
Eur Heart J Qual Care Clin Outcomes
Management of atrial fibrillation in seven European countries after the publication of the 2010 ESC Guidelines on atrial fibrillation: primary results of the PREvention oF thromboemolic events–European Registry in atrial fibrillation (PREFER in AF)
Europace
Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: a randomized clinical trial
JAMA
Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham heart study
JAMA
Educational interventions to improve outcomes in patients with atrial fibrillation-a systematic review
Int J Clin Pract
Quality of life in patients with atrial fibrillation: a systematic review
Am J Med
Cited by (0)
Funding: none.