The impact of catheter ablation for atrial fibrillation (AF) on cardiovascular events and mortality is controversial. We investigated the impact of sinus rhythm maintenance on major adverse cardiac and cerebrovascular events after AF ablation from a Japanese multicenter cohort of AF ablation. We investigated 3326 consecutive patients (25.8% female, mean age 63.3 ± 10.3 years) who underwent catheter ablation for AF from the atrial fibrillation registry to follow the long-term outcomes and use of anti coagulants after ablation (AF frontier ablation registry). The primary endpoint was a composite of stroke, transient ischemic attack, cardiovascular events, and all-cause death. During a mean follow-up of 24.0 months, 2339 (70.3%) patients were free from AF after catheter ablation, and the primary composite endpoint occurred in 144 (4.3%) patients. The AF nonrecurrence group had a significantly lower incidence of the primary endpoint (1.8 per 100 person-years) compared with the AF recurrence group (3.0 per 100 person-years, p = 0.003). The multivariate analysis revealed that freedom from AF (hazard ratio 0.61, 95% confidence interval 0.44–0.86, p = 0.005) was independently associated with the incidence of the composite event. In the multicenter cohort of AF ablation, sinus rhythm maintenance after catheter ablation was independently associated with lower rates of major adverse cardiac and cerebrovascular events.

房颤（AF）导管消融对心血管事件和死亡率的影响存在争议。我们调查了来自日本多中心房颤消融队列的窦性心律维持对房颤消融后主要不良心脑血管事件的影响。我们调查了 3326 名连续患者（25.8% 女性，平均年龄 63.3 ± 10.3 岁），他们从心房颤动登记处接受了 AF 导管消融术，以跟踪消融后的长期结果和抗凝剂的使用（AF 前沿消融登记处）。主要终点是中风、短暂性脑缺血发作、心血管事件和全因死亡的复合终点。在平均 24.0 个月的随访期间，2339 名（70.3%）患者在导管消融后没有发生 AF，主要复合终点发生在 144 名（4.3%）患者中。p  = 0.003)。多变量分析显示，无房颤（风险比 0.61，95% 置信区间 0.44-0.86，p  = 0.005）与复合事件的发生率独立相关。在 AF 消融的多中心队列中，导管消融后维持窦性心律与较低的主要不良心脑血管事件发生率独立相关。