• T Jared Bunch, Brian G Crandall, J Peter Weiss, Heidi T May, Tami L Bair, Jeffrey S Osborn, Jeffrey L Anderson, Joseph B Muhlestein, Benjamin D Horne, Donald L Lappe, and John D Day.
• Intermountain Heart Rhythm Specialists Department of Cardiology, Intermountain Medical Center, Murray, Utah 84107, USA. Thomas.bunch@imail.org
• J. Cardiovasc. Electrophysiol. 2011 Aug 1; 22 (8): 839-45.

Introduction Atrial fibrillation (AF) adversely impacts mortality, stroke, heart failure, and dementia. AF ablation eliminates AF in most patients. We evaluated the long-term impact of AF ablation on mortality, heart failure (HF), stroke, and dementia in a large system-wide patient population.Methods A total of 4,212 consecutive patients who underwent AF ablation were compared (1:4) to 16,848 age/gender matched controls with AF (no ablation) and 16,848 age/gender matched controls without AF. Patients were enrolled from the large ongoing prospective Intermountain AF study and were followed for at least 3 years.Results Of the 37,908 patients, mean age 65.0 ± 13 years, 5,667 (14.9%) died, 1,296 (3.4%) had a stroke, and 1,096 (2.9%) were hospitalized for HF over >3 years of follow-up. AF ablation patients were less likely to have diabetes, but were more likely to have hypertension, HF, and significant valvular heart disease. AF ablation patients had a lower risk of death and stroke in comparison to AF patients without ablation. Alzheimer's dementia occurred in 0.2% of the AF ablation patients compared to 0.9% of the AF no ablation patients and 0.5% of the no AF patients (P < 0.0001). Other forms of dementia were also reduced significantly in those treated with ablation. Compared to patients with no AF, AF ablation patients had similar long-term rates of death, dementia, and stroke.Conclusions AF ablation patients have a significantly lower risk of death, stroke, and dementia in comparison to AF patients without ablation. AF ablation may eliminate the increased risk of death and stroke associated with AF.© 2011 Wiley Periodicals, Inc.

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