A-Fib Catheter Ablation Cuts Risk for Ischemic Stroke After 30 Days, Mortality, Heart Failure Hospitalization
MONDAY, July 7, 2025 -- For patients with atrial fibrillation, catheter ablation reduces the risks for ischemic stroke at more than 30 days, mortality, and heart failure hospitalization, while surgical ablation only reduces stroke risk, according to a review published online July 1 in the Annals of Internal Medicine.
Bryce Montane, M.D., from Washington University in St. Louis, and colleagues examined the effect of ablation on several outcomes, including ischemic stroke, mortality, and heart failure hospitalization in a review of randomized controlled trials of catheter or surgical ablation versus no ablation that had at least one month of follow-up.
The researchers found that catheter ablation reduced risks for ischemic stroke after 30 days, mortality, and heart failure hospitalization compared with medical therapy (relative risks [95 percent confidence intervals], 0.63 [0.43 to 0.92], 0.73 [0.60 to 0.88], and 0.68 [0.55 to 0.85], respectively). However, catheter ablation also increased the relative risk for ischemic stroke at or before 30 days (relative risk, 6.81; 95 percent confidence interval, 1.56 to 29.8), such that the relative risks (95 percent confidence intervals) for ischemic stroke and stroke from any cause were 0.77 (0.55 to 1.09) and 0.77 (0.57 to 1.05). Surgical ablation reduced the relative risks (95 percent confidence intervals) for ischemic stroke and stroke from any cause (0.54 [0.34 to 0.86] and 0.54 [0.35 to 0.82]); for other outcomes, benefits were uncertain.
"Catheter ablation reduced the risks for ischemic stroke after 30 days, mortality, and heart failure hospitalization," the authors write. "Surgical ablation reduced risks for ischemic stroke and strokes from any cause but had uncertain benefit for other outcomes."
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