Atrial Fibrillation Recurrence Risk After Catheter Ablation in Patients With Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

Abstract

Background: The association between rheumatoid arthritis (RA) and the risk of developing atrial fibrillation (AF) is well-established. However, data on the impact of RA on AF recurrence postcatheter ablation (CA) remain unclear. This current study aimed to assess the impact of RA on AF recurrence after catheter-based pulmonary vein isolation. Methods: Potentially eligible studies were identified from Medline and EMBASE databases from inception to December 20, 2023. Eligible study must consist of two cohorts of patients with and without RA who underwent catheter ablation for AF. Pooled risk ratio (RR) and 95% CI were calculated using Dersimonian and Laird's random-effect, generic inverse variance approach. Results: The meta-analysis includes three retrospective cohort studies with a total of 700 patients. The pooled analysis found a significantly increased risk of AF recurrence after CA among patients with RA compared to patients without RA with the pooled RR of 1.59 (95% CI, 1.10–2.29, I2 14%). Increased risk of early recurrence (within 90 days) was also observed with the pooled RR of 2.70 (95% CI, 1.74–4.19, I2 0%). Conclusions: The current study found that patients with RA have a higher risk of AF recurrence after CA for AF, including the risk of early recurrence.