Observational studyJAMA network open2026
Diagnosis-to-Ablation Time and Atrial Arrhythmia Recurrence After Ablation.
Observational study in JAMA network open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
23 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Importance: Diagnosis-to-ablation time (DAT) has emerged as a potential predictor of ablation outcomes in atrial fibrillation (AF). Limited evidence is available on the association of prolonged DAT, and existing studies are constrained by small sample sizes and methodological heterogeneity. Objective: To evaluate whether DAT is associated with atrial arrhythmia recurrence following radiofrequency ablation (RFA) for AF. Design, Setting, and Participants: In this cohort study, patients with AF undergoing de novo RFA from January 2018 to June 2023 in a large, multicenter, clinical practice registry were included. Data were analyzed in August 2024. Exposure: Available DAT and 1-year postablation follow-up. Main Outcomes and Measures: Multivariable Cox regression was used to assess the association between DAT and recurrent atrial arrhythmia (post-blanking period). Results: A total of 3724 patients were included (1492 [40.1%] female; mean [SD] age, 67.0 [10.0] years; mean [SD] BMI, 31.0 [6.8]; and mean [SD] CHA2DS2-VASc score, 2.8 [1.5]). The median (IQR) DAT was 1 (0-4) year, and 2412 (64.8%) underwent RFA for paroxysmal AF. Compared with patients with DAT of less than 1 year, after adjusting for baseline characteristics and comorbidities, patients with DAT of 1 to 4 years had a 48% higher risk of all atrial arrhythmia recurrence (hazard ratio [HR], 1.48; 95% CI, 1.08-2.01; P = .01), and those with DAT greater than 5 years had a 110% increased risk (HR, 2.10; 95% CI, 1.46-3.02; P < .001). Conclusions and Relevance: In this cohort study of patients undergoing de novo RFA, longer DAT was associated with an increased risk of atrial arrhythmia recurrence at 1 year. These results suggest that delayed referral for ablation may be an important prognostic marker in contemporary clinical practice.
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