Insomnia is related to long-term atrial fibrillation recurrence following radiofrequency ablation

Abstract

Objective

Atrial fibrillation (AF), the most common cardiac arrhythmia, presents significant health challenges, and the intricate connection between insomnia and AF has garnered substantial attention. This cohort study aims to investigate the relationship between insomnia and AF recurrences following radiofrequency ablation.

Materials and Methods

Data were retrieved from an electronic database of patients who underwent radiofrequency ablation for AF. The primary endpoint was AF recurrence. We utilized a multivariable Cox model, coupled with three propensity score methods, for analysis.

Results

Between January 1, 2017, and June 1, 2022, 541 patients who underwent radiofrequency ablation for AF were recorded in the database. After excluding 185 patients, the final cohort comprised 356 patients. Among them, 68 were afflicted by insomnia, while 288 were not. Over a median follow-up of 755 days, one patient died, and 130 (36.5%) experienced AF recurrence. Multivariate Cox regression analysis revealed that the insomnia group had a higher risk of AF recurrence compared to the non-insomnia group (HR: 1.83, 95% CI: 1.16–2.89). Further landmark analysis showed no significant difference in AF recurrence rates during the initial 1-year follow-up. However, beyond 1 year, the insomnia group demonstrated a significantly higher AF recurrence rate. As the number of insomnia symptoms increased, the risk of AF recurrence also rose significantly, indicating a dose-response relationship.

Conclusion

This study establishes a significant link between insomnia and long-term AF recurrence following radiofrequency ablation. It underscores the importance of identifying and addressing insomnia in patients with AF undergoing radiofrequency ablation.

Keywords:

• Atrial fibrillation
• catheter ablation
• insomnia

Acknowledgements

The authors also thank Yi-chen Li for data collection.

Authors contributions

JZ and XC acquired the data, and RL performed the statistical analyses, interpreted the data, and drafted and revised the manuscript. WC interpreted the data, designed the study, revised the manuscript for important intellectual content and approved the final version. All authors have read and approved the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Availability of data and materials

The relevant raw data of this article will be made available upon request by the authors.

Additional information

Funding

This study was supported by the Department of Science and Technology of Hebei Province (Grant number: 22377749D) and the Medical Research Program of Hebei Province (Grant numbers: 20230580 and 20241654).