AIMS: Catheter ablation (CA) is an established treatment for atrial fibrillation (AF). A computed tomography (CT) may be performed before ablation to evaluate the anatomy of pulmonary veins. The aim of this study is to investigate the prevalence of patients with coronary artery disease (CAD) detected by cardiac CT scan pre-ablation and to evaluate the impact of CAD and revascularization on outcomes after AF ablation.METHODS AND RESULTS: All consecutive patients with AF diagnosis, hospitalized at Universitair Ziekenhuis Brussel, Belgium, between 2015 and 2019, were prospectively screened for enrolment in the study. Inclusion criteria were (i) AF diagnosis, (ii) first procedure of AF ablation with cryoballoon CA, and (iii) contrast CT scan performed pre-ablation. A total of 576 consecutive patients were prospectively included and analysed in this study. At CT scan, 122 patients (21.2\%) were diagnosed with CAD, of whom 41 patients (7.1\%) with critical CAD. At survival analysis, critical CAD at CT scan was a predictor of atrial tachyarrhythmia (AT) recurrence during the follow-up, only in Cox univariate analysis [hazard ratio (HR) = 1.79] but was not an independent predictor in Cox multivariate analysis. At Cox multivariate analysis, independent predictors of AT recurrence were as follows: persistent AF (HR = 2.93) and left atrium volume index (HR = 1.04).CONCLUSION: In patients undergoing CT scan before AF ablation, critical CAD was diagnosed in 7.1\% of patients. Coronary artery disease and revascularization were not independent predictors of recurrence; thus, in this patient population, AF ablation should not be denied and can be performed together with CAD treatment.
Cappello, IA, Pannone, L, Della Rocca, DG, Sorgente, A, Del Monte, A, Mouram, S, Vetta, G, Kronenberger, R, Ramak, R, Overeinder, I, Bala, G, Almorad, A, Ströker, E, Sieira, J, La Meir, M, Belsack, D, Sarkozy, A, Brugada, P, Tanaka, K, Chierchia, GB, Gharaviri, A & de Asmundis, C 2023, 'Coronary artery disease in atrial fibrillation ablation: impact on arrhythmic outcomes', Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, vol. 25, no. 12, euad328. https://doi.org/10.1093/europace/euad328
Cappello, I. A., Pannone, L., Della Rocca, D. G., Sorgente, A., Del Monte, A., Mouram, S., Vetta, G., Kronenberger, R., Ramak, R., Overeinder, I., Bala, G., Almorad, A., Ströker, E., Sieira, J., La Meir, M., Belsack, D., Sarkozy, A., Brugada, P., Tanaka, K., ... de Asmundis, C. (2023). Coronary artery disease in atrial fibrillation ablation: impact on arrhythmic outcomes. Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, 25(12), Article euad328. https://doi.org/10.1093/europace/euad328
@article{79b8e580f47d489d8240200a294afc85,
title = "Coronary artery disease in atrial fibrillation ablation: impact on arrhythmic outcomes",
abstract = "AIMS: Catheter ablation (CA) is an established treatment for atrial fibrillation (AF). A computed tomography (CT) may be performed before ablation to evaluate the anatomy of pulmonary veins. The aim of this study is to investigate the prevalence of patients with coronary artery disease (CAD) detected by cardiac CT scan pre-ablation and to evaluate the impact of CAD and revascularization on outcomes after AF ablation.METHODS AND RESULTS: All consecutive patients with AF diagnosis, hospitalized at Universitair Ziekenhuis Brussel, Belgium, between 2015 and 2019, were prospectively screened for enrolment in the study. Inclusion criteria were (i) AF diagnosis, (ii) first procedure of AF ablation with cryoballoon CA, and (iii) contrast CT scan performed pre-ablation. A total of 576 consecutive patients were prospectively included and analysed in this study. At CT scan, 122 patients (21.2\%) were diagnosed with CAD, of whom 41 patients (7.1\%) with critical CAD. At survival analysis, critical CAD at CT scan was a predictor of atrial tachyarrhythmia (AT) recurrence during the follow-up, only in Cox univariate analysis [hazard ratio (HR) = 1.79] but was not an independent predictor in Cox multivariate analysis. At Cox multivariate analysis, independent predictors of AT recurrence were as follows: persistent AF (HR = 2.93) and left atrium volume index (HR = 1.04).CONCLUSION: In patients undergoing CT scan before AF ablation, critical CAD was diagnosed in 7.1\% of patients. Coronary artery disease and revascularization were not independent predictors of recurrence; thus, in this patient population, AF ablation should not be denied and can be performed together with CAD treatment.",
author = "Cappello, \{Ida Anna\} and Luigi Pannone and \{Della Rocca\}, \{Domenico Giovanni\} and Antonio Sorgente and \{Del Monte\}, Alvise and Sahar Mouram and Giampaolo Vetta and Rani Kronenberger and Robbert Ramak and Ingrid Overeinder and Gezim Bala and Alexandre Almorad and Erwin Str{\"o}ker and Juan Sieira and \{La Meir\}, Mark and Dries Belsack and Andrea Sarkozy and Pedro Brugada and Kaoru Tanaka and Chierchia, \{Gian Battista\} and Ali Gharaviri and \{de Asmundis\}, Carlo",
note = "Publisher Copyright: {\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.",
year = "2023",
month = dec,
day = "6",
doi = "10.1093/europace/euad328",
language = "English",
volume = "25",
journal = "Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology",
issn = "1099-5129",
publisher = "Oxford University Press",
number = "12",
}