Catheter ablation for atrial fibrillation (AF) has been an established and frequently utilized approach in a variety of clinical settings. Nevertheless, real-world data about the clinical course of AF patients after initial catheter ablation remain limited, and these are mainly derived from particular registries or selected high-volume centers.

In this study, we used health check-ups and insurance claims database from a Japanese insurance organization. The study population was comprised of 1777 patients who underwent catheter ablation for AF before June 2016. During the 3-year follow-up period, 396 (22.3%) patients underwent at least one repeated AF ablation, while 74 (4.2%) underwent two or more repeated ablations. In multivariate Cox regression analysis, longer time after AF diagnosis (7-11 months and ≥12 months versus 1-6 months) (HR, 1.05; 95% CI, 1.01-1.08 and HR, 1.04; 95% CI 1.02-1.07) was independently associated with repeated ablation. The discontinuation rates of OACs and AADs after the first ablation were 26.7% and 63.0% at 3 months and 75.2% and 89.1% at 1 year after the initial ablation, respectively. The former was independently associated with shorter time after AF diagnosis and lower diastolic blood pressure, whereas the latter was independently associated with older age, smaller CHADS₂ score, and shorter time after AF diagnosis.

We presented real-world data regarding the clinical course of young Japanese AF patients after initial catheter ablation based on a claims database in Japan.

心房颤动 (AF) 的导管消融已成为各种临床环境中已建立且经常使用的方法。然而，关于初始导管消融后 AF 患者临床过程的真实世界数据仍然有限，这些数据主要来自特定注册中心或选定的高容量中心。

在这项研究中，我们使用了日本保险机构的健康检查和保险索赔数据库。研究人群由 1777 名在 2016 年 6 月之前因 AF 接受导管消融的患者组成。 在 3 年随访期间，396 名 (22.3%) 患者接受了至少一次重复房颤消融，而 74 名 (4.2%) 接受了两次或更多次重复消融。在多变量 Cox 回归分析中，AF 诊断后的时间更长（7-11 个月和≥12 个月对比 1-6 个月）（HR，1.05；95% CI，1.01-1.08 和 HR，1.04；95% CI 1.02-1.07）与重复消融独立相关。第一次消融后 OACs 和 AADs 的停药率在 3 个月时分别为 26.7% 和 63.0%，在初次消融后 1 年时分别为 75.2% 和 89.1%。₂分，AF 诊断时间更短。

我们根据日本的索赔数据库提供了有关初始导管消融后年轻日本 AF 患者临床过程的真实世界数据。