Early ablation is linked to lower cardiovascular risk after stroke
At 36 months, early ablation was linked to 1.54 more event-free months and an 11.17% absolute risk reduction in major adverse cardiovascular events versus medical therapy.
Neurology
In a retrospective study of 431 human patients aged 18 to 85 years with atrial fibrillation and a history of ischemic stroke, researchers emulated a target trial comparing early catheter ablation with medical therapy. Among the participants across six Chinese centers (median age 70 years; 37% female), 207 underwent early ablation, with a median follow-up of 3.0 years. At 36 months, early ablation was associated with a gain of 1.54 major adverse cardiovascular event-free months and an absolute risk reduction of 11.17%. Early ablation was also linked to an 11.98% higher event-free survival rate for cardiovascular rehospitalization. In a propensity-matched cohort of 250 patients, ablation was linked to better functional scores and lower odds of cognitive impairment on a post hoc assessment.
Why it matters
Stroke and atrial fibrillation frequently co-occur in older adults, compounding late-life disability and vascular decline. These findings suggest that procedural rhythm control may help preserve cardiovascular and neurological function in high-risk patients.
Caveats
The study relies on retrospective observational data and target trial emulation, which leaves potential for residual confounding. Furthermore, cognitive outcomes were evaluated using a post hoc assessment, and findings require validation in randomized trials.
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