Management of risk factors important in A-fib ablation

(HealthDay)—Aggressive management of risk factors improves the long-term outcomes in patients receiving catheter ablation for atrial fibrillation (AF), according to research published in the Dec. 2 issue of the Journal of the American College of Cardiology.

Rajeev K. Pathak, M.B.B.S., of the University of Adelaide in Australia, and colleagues conducted a cohort study in which 149 of 281 consecutive patients undergoing AF ablation were offered risk factor management (RFM) addressing risk factors such as body weight, blood pressure, glycemic control, and lipid levels. After AF ablation, outcomes were monitored among 61 patients receiving RFM and 88 controls.

The researchers found that patients undergoing AF ablation who received RFM had significantly improved outcomes, including greater reductions in weight and blood pressure, better glycemic control, and more favorable lipid profiles. Compared with the control group, the RFM group showed greater reductions in frequency, duration, symptoms, and symptom severity for AF. Both single-procedure drug-unassisted arrhythmia-free survival and multiple-procedure arrhythmia-free survival were significantly greater in RFM patients compared with controls. In multivariate analysis, RFM was an independent predictor of arrhythmia-free survival (hazard ratio, 4.8; P < 0.001).

"In summary, the authors are to be commended for rigorously applying 'aggressive' RFM and demonstrating its beneficial effects on long-term success after catheter ablation of AF," writes the author of an accompanying editorial.

Several study authors and the editorialist disclosed financial ties to pharmaceutical and biomedical companies.