Abstract
Introduction: Atrial fibrillation (AF) ablation for military personnel aims to provide therapeutic endpoints, recognizing that a subset of personnel require repeat ablation. Objective: This study aims to identify differences in characteristics and occupations of military members who received single versus repeat AF ablation. Further, we aim to understand the rates retention and deployment in those with single versus repeat AF ablation. Hypothesis: We hypothesize that there are increased rates of AF repeat ablations in personnel with risk factors for AF recurrence. Methods: Military personnel who underwent elective AF ablation between 2004 to 2019 were reviewed. Characteristics and military dispositions of personnel with repeated AF ablations were compared to those without. Results: 27 of 104 (26%) personnel received repeat AF catheter ablations on average 16.1±31 months after first ablation. There were no differences between age (34.5+9.5 vs 37.6+9.8 years, P=0.13), BMI (28.1±3.9 vs 28.7±3.4 kg/m2, P=0.48), presence of diastolic dysfunction (11.7% vs 7.4%, P=0.53), left atrial appendage emptying velocities (58.4+22 vs 59.7+23 cm/s, P=0.82), left atrial volume index (29.4+9.9 vs 29.6+8.8 ml/m2, P=0.87), left ventricular ejection fraction (60.4+6% vs 58.5+13%, P=0.31), CHA2DS2-VASc scores (0.37+0.6 vs 0.44+0.7, P=0.60) between those who received a single versus repeated AF ablation. Aviators (40%, 4/10) and healthcare workers (35%, 12/34) underwent repeated ablation at significantly increased rates when compared to 22% of administrators (4/18) and 10% of industrial workers (2/20), (P=0.032). Military retention rates were preserved in those requiring repeated ablation compared to those with single AF ablation (70%, 19/27 vs 78%, 60/77; P=0.60). Deployment rates were statistically similar between those requiring repeated AF ablation compared to single ablation (37%, 10/27 vs 43%, 33/77; P=0.43). Conclusions: Repeat AF catheter ablation rates in military tactical athletes may be driven by specific and individual occupational demands without increased traditional risk factors for AF recurrence. Military retention and deployment rates are preserved for those requiring repeated AF ablation compared to those with single ablation.
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