Abstract 4361939: Impact of Atrial Fibrillation Ablation on Patients with Amyloidosis: A Real-World Propensity Score-Matched Study

Introduction: Patients with amyloidosis and atrial fibrillation experienced poorer outcomes. The effect of atrial ablation on patients diagnosed with amyloidosis remains unclear. Research question: To assess the effects of ablation therapy on patients diagnosed with amyloidosis who also have atrial fibrillation. Methods: A retrospective analysis utilizing propensity score matching was conducted with global real-world data sourced from TrinetX. Patients diagnosed with amyloidosis (International Classification of Diseases, 10th Revision, Clinical Modification [ICD-10-CM] codes: E85.x) and atrial fibrillation (ICD-10-CM code: I48.x) were included in the study. The participants in the study were categorized into two distinct groups: the ablation group and the non-ablation group. The outcomes measured included all-cause mortality, ischemic stroke, and instances of acute heart failure. Results: A total of 1,416 patients were evaluated in the ablation group, whereas 27,459 patients were evaluated in the non-ablation group. Following propensity score matching based on sex, age, antiarrhythmic medications and comorbidities, the ablation group exhibited a significantly lower all-cause mortality rate compared to the control group, with respective rates of 12.41% and 30.56% (risk ratio [RR]: 0.40, 95% confidence interval [CI]: 0.34–0.47) over a 5-year follow-up period. Additionally, there was a significantly reduced risk of ischemic stroke in the ablation group, with rates of 8.93% versus 16.17% (RR: 0.55, 95% CI: 0.45–0.67). Furthermore, the incidence of acute heart failure events was lower in the ablation group, with rates of 35.67% compared to 41.41% (RR: 0.78, 95% CI: 0.78–0.94). Conclusions: Atrial fibrillation ablation has the potential to lower the risk of all-cause mortality, stroke, and acute heart failure events in patients diagnosed with amyloidosis who also experience concurrent atrial fibrillation.