Early ablation lowers cardiac risks in stroke patients with AF
At 36 months, early ablation yielded a 1.54-month gain in event-free survival and an 11.17% absolute risk reduction in major adverse cardiovascular events versus medical therapy.
Neurology
In human patients aged 18 to 85 years with atrial fibrillation and prior ischemic stroke, researchers emulated a target trial across six Chinese centers to evaluate early catheter ablation against medical therapy. The study analyzed 431 patients with a median age of 70 years over a median follow-up of 3.0 years, with 207 participants undergoing catheter ablation within a one-year grace period.
Beyond reducing major adverse cardiovascular events, early ablation was associated with an 11.98% higher 36-month event-free survival rate for cardiovascular rehospitalization. In a matched cohort of 250 patients, ablation also tracked with better functional scores on the modified Rankin Scale (adjusted odds ratio 0.31) and lower odds of cognitive impairment on post hoc AD8 assessments (adjusted odds ratio 0.42).
Why it matters
Atrial fibrillation is a common age-related arrhythmia that contributes to secondary cerebrovascular events and downstream neurodegeneration. Managing cardiac rhythm through early intervention may help older adults maintain functional independence and preserve cognitive health after an initial stroke.
Caveats
The findings rely on a retrospective observational design and target trial emulation rather than randomized allocation, leaving open the risk of residual confounding. In addition, cognitive status was assessed post hoc, and the authors emphasize that larger randomized controlled trials are required.
The paper
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Enming Cui, Haocen Guo, Qiuheng Bian, Youmei Shen, Zhoushan Gu, Xiangwei Ding, Linlin Wang, Boshui Huang, Xuefeng Zhu, Mingfang Li, 陈红武, Weizhu Ju, Gang Yang, Kai Gu, Hailei Liu,Nanjing Medical University
Neurology · 1 Oct 2026