Shorter Time From Diagnosis-to-Ablation Decreases Atrial Fibrillation Recurrence

In patients with symptomatic atrial fibrillation, a shorter time from diagnosis to ablation decreases risk for recurrent atrial fibrillation.

Decreased time from diagnosis to ablation is associated with lower rates of postablation atrial fibrillation (AF) recurrence, according to results from a systematic review and meta-analysis presented at the American College of Cardiology (ACC) 2023 conference, held from March 4 to 6, 2023, in New Orleans, Louisiana.

The success of an ablation procedure depends, in part, on diagnosis-to-ablation time and is an important predictor for freedom from AF. Despite this relationship, it remains unclear what the relationship is between diagnosis-to-ablation time and postablation AF recurrence.

To better understand this relationship, investigators from Thomas Jefferson University in the United States and Dow Medical College in Pakistan searched publication databases through August 2022 for studies evaluating the effect of diagnosis-to-ablation time on AF recurrence at 1 and 3 years.

A total of 8 studies comprising 16,093 patients were included in the analysis. All studies were of observational design and were published between 2013 and 2022.

Among the 7 individual studies that compared outcomes for diagnosis-to-ablation time of 1 or fewer years with outcomes for longer than 1 year, 5 significantly favored shorter diagnosis-to-ablation time (risk ratio [RR] range, 0.61-0.86). In the pooled meta-analysis, diagnosis-to-ablation time at 1 or fewer years was associated with decreased risk for postablation AF recurrence (RR, 0.76; 95% CI, 0.66-0.86; I2, 82%; P <.0001).

In the 3 studies that compared outcomes after diagnosis-to-ablation time at 3 or fewer years with outcomes for longer than 3 years, all 3 favored shorter diagnosis-to-ablation time (RR range, 0.75-0.82). Similarly, in the meta-analysis, the shorter diagnosis-to-ablation time was associated with a lower risk for AF recurrence (RR, 0.77; 95% CI, 0.72-0.83; I2, 0%; P <.00001).

Limitations of this study include the few available studies and the lack of any randomized controlled trials evaluating the relationship between diagnosis-to-ablation timing and AF recurrence.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Najeeb H, Zaidi SF, Moeed A, et al. Diagnosis-to-ablation time as a predictor of recurrence of atrial fibrillation following catheter ablation: a systematic review and meta-analysis. Abstract presented at: ACC 2023; March 4-6, 2023; New Orleans, LA. 1098-001/001.