The impact of height on recurrence after index catheter ablation of paroxysmal atrial fibrillation.

PURPOSE: The relationship between height and incident atrial fibrillation (AF) has recently been demonstrated. We aimed to evaluate the impact of height on outcomes of ablation in patients with drug-refractory symptomatic paroxysmal AF (PAF). METHODS: A total of 689 patients (470 males; age, 53.0 ± 11.7 years) with symptomatic paroxysmal AF receiving index catheter ablation (CA) between 2003 and 2013 were enrolled in this study. The baseline characteristics, ablation, and follow-up results were evaluated. The patients were categorized according to the quartiles of height for each sex. RESULTS: Patients in the lower quartiles of height had a lower incidence of AF recurrence (log-rank p = 0.022). Height in female patients was strongly associated with AF recurrence (p = 0.027) after an index ablation in the 6.33 ± 4.32 years of follow-up. Female patients > 159 cm in height had a higher likelihood of AF recurrence after index CA (HR = 2.01, 95% CI: 1.24-3.25, p = 0.005) than that in those below this height. In computed tomography (CT) scan, the superoinferior diameter of the left atrium (LA) correlated with body height in females, but not in male patients. CONCLUSIONS: Height is associated with AF recurrence after the index CA of PAF in female patients. In Asian populations, women above height 159 cm are twice as likely to have AF recurrence post-ablation as shorter women.

Atrial Fibrillation Risk and Urate-Lowering Therapy in Patients with Gout: A Cohort Study Using a Clinical Database.

Individuals of Asian descent are at higher risk for developing hyperuricemia and gout as compared to Western populations. Urate-lowering therapy (ULT) is an effective treatment for hyperuricemia and gout. It was reported that febuxostat, one of the ULTs, raises the risk of atrial fibrillation (AF) in elderly populations. Nevertheless, this association has not been properly investigated in Asian populations. We aimed to investigate the development of AF after ULT with different drugs in an Asian population. We conducted a retrospective cohort study using the clinical database at Kaohsiung Veterans General Hospital. Patients newly diagnosed with gout between 1 January 2013 and 31 December 2020 and with a documented baseline serum uric acid (sUA) level but no prior diagnosis of AF were identified. Patients were divided into three groups-allopurinol, benzbromarone, and febuxostat users. During the follow-up period, the risks of incident AF following the initiation of ULT with different drugs were assessed. Development of incident AF was noted in 43 (6%) of the 713 eligible patients during the follow-up period (mean, 49.4 ± 26.6 months). Febuxostat-treated patients had a higher prevalence of certain comorbidities (diabetes mellitus, heart failure, and chronic kidney disease) and higher CHA2DS2-VASc scores. Compared with allopurinol, neither febuxostat nor benzbromarone was associated with increased adjusted hazard ratios (HR) for incident AF (HR: 1.20, 95% confidence interval [CI]: 0.43-3.34; HR: 0.68, 95% CI: 0.22-2.08). There was no difference in the risk of incident AF among Asian patients with gout who received febuxostat, allopurinol, or benzbromarone. Further studies are needed to evaluate long-term cardiovascular outcomes in patients receiving different ULT drugs.