Presence and extent of coronary artery disease as predictor for AF recurrences after catheter ablation: The Leipzig Heart Center AF Ablation Registry

Abstract

BackgroundOcclusion of the right coronary artery (RCA) may promote atrial fibrillation (AF) by creating a right atrial substrate. However, the presence and extent of coronary artery disease (CAD) is usually not considered to tailor AF ablation strategies. This study was aimed to analyze the possible association between the presence and extent of CAD and rhythm outcomes of left-atrial AF catheter ablation. Methods1310 patients (60±10years, 67% males, 63% paroxysmal AF) from The Leipzig Heart Center AF Ablation Registry undergoing de novo AF catheter ablation were included. CAD was defined as stenosis≥50% in the left main coronary artery and ≥70% in one or several of the major coronary arteries. AF recurrences were defined as any atrial arrhythmia lasting >30s and occurring within the first week (early recurrences, ERAF) or between 3 and 12months (late recurrences, LRAF) after ablation and were assessed with serial 7-day Holter ECG. Results152 patients (11.6%) had significant CAD; 89 (59%) had one, 35 (23%) two and 28 (18%) three vessel disease; 72 (47%) patients had RCA involvement. Occurrence of AF recurrences was comparable in CAD (p=0.625 and 0.568 for ERAF and LRAF, respectively). Among patients with CAD, neither the location (RCA versus non-RCA) nor the extent of CAD (single versus multiple vessel disease) was associated with rhythm outcomes after AF catheter ablation (all p>0.05). ConclusionThe presence and extent of CAD seem not to impact on rhythm outcome of AF catheter ablation in the entire cohort.