B-PO03-084 CATHETER ABLATION FOR ATRIAL FIBRILLATION IN HYPERTHYROID PATIENTS

Abstract

The outcome and safety of catheter ablation for atrial fibrillation (AF) in hyperthyroid patients is unknown. To investigate the outcome and safety of catheter ablation in hyperthyroid AF patients. We enrolled AF patients that were hyperthyroid at the time of ablation at the University Hospital Bordeaux from 2011 to 2020. The primary outcome was recurrence of AF or atrial tachycardia. Hyperthyroid patients were compared to 1:2 propensity-score matched, euthyroid controls. In 39 hyperthyroid patients, mean age was 60 years, 77% were male and 77% had persistent AF. Mean TSH levels were 0.1 μUI/mL. Hyperthyroidism was amiodarone-induced in 80%, was overt in 61.5% and subclinical in 38.5% of the patients. At the ablation procedure, all pulmonary veins could be isolated, and all cavotricuspid isthmus lines, 93% of lateral mitral isthmus lines and 94% of roof lines blocked. No serious periprocedural complications occurred. Over a mean follow-up of 1.6 years, 19 hyperthyroid patients experienced an arrhythmia recurrence corresponding to 39% at 6 months, 55% at 12 months and 60% at 18 months. Compared to the matched, euthyroid cohort, the recurrence rate was higher in hyperthyroid patients (logrank p=0.003). Catheter ablation for AF in hyperthyroid patients is associated with a high acute success rate and no increased risk for periprocedural complications. Long-term success is lower in hyperthyroid compared to euthyroid patients.