Original Investigation

Catheter Ablation vs Drug Therapy in Patients With Atrial Fibrillation and Nonmodifiable Recurrence Risk Factors

JAMA Network Open 10.1001/jamanetworkopen.2025.28124

August 21, 2025 at 11:00 AM EDT

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Are nonmodifiable recurrence risk factors (NMRRFs) associated with differences in benefit of catheter ablation compared with drug therapy in patients with atrial fibrillation (AF)?In this subanalysis of 2185 patients enrolled in the Catheter Ablation vs Anti-Arrhythmic Drug Therapy for Atrial Fibrillation randomized clinical trial, catheter ablation reduced the primary composite end point of death, disabling stroke, serious bleeding, or cardiac arrest in patients with fewer than 3 NMRRFs. However, it showed no significant benefit of the primary composite end point in patients with 3 or more NMRRFs.The findings suggest that catheter ablation could improve the cardiovascular prognosis for individuals with AF with fewer than 3 NMRRFs, laying the foundation for more personalized AF management and research in the field.

Corresponding Authors: Changsheng Ma, MD, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2, Anzhen Road, Chao Yang District, Beijing 100029, China (chshma@vip.sina.com).

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