Multimorbidity increases risk of atrial fibrillation recurrence after cryoballoon ablation

Background and Aims: Despite advancements in atrial fibrillation (AF) catheter ablation techniques, atrial arrhythmia recurrence after the procedure remains common. Although individual comorbidities are known to affect ablation outcomes, the role of multimorbidity is unclear. This study aimed to investigate the association between multimorbidity and atrial arrhythmia recurrence after cryoballoon AF ablation.

Methods: The cryoballoon ablation study is a single-center, prospective registry including 349 consecutive patients undergoing cryoballoon AF ablation. The presence of eleven comorbidities was assessed and the population divided into two groups: no multimorbidity (0–1 comorbidity) and multimorbidity (≥2 comorbidities). Clinical follow-up visits combined with 12-lead ECG and 24-hour Holter monitoring were scheduled at 3, 6 and 12 months post-procedure. Cox proportional hazard regression analyses were conducted to assess the association with atrial arrhythmia recurrence. Kaplan-Meier estimates for the cumulative risk of the first recurrence were calculated and plotted.

Results: The mean age was 62 ± 9 years and 123 (35 %) were women. Multimorbidity was present in 184 (53 %) patients. During a median follow-up of 328 [IQR 203–409] days, 114 patients (33 %) experienced atrial arrythmia recurrence within one year after cryoballoon AF ablation. Cox proportional hazard regression analyses, adjusted for age and sex, revealed a significant association between multimorbidity (HR 1.64, 95 % CI 1.12–2.39) and atrial arrhythmia recurrence. Furthermore, hypertension (HR 1.58, 95 % CI 1.01–2.49) and obesity (HR 1.63, 95 % CI 1.09–2.42) were associated with recurrence at one year post-ablation.

Conclusion: In AF patients undergoing cryoballoon AF ablation, multimorbidity was associated with atrial arrhythmia recurrence within one year post-ablation.