Safety and Real-World Outcomes of Catheter Ablation for Atrial Arrhythmias in Patients with Substance Use Disorder

Abstract Purpose: Evidence guiding catheter ablation for atrial fibrillation (AF) or atrial flutter (AFL) in patients with substance use disorder (SUD) remains limited despite frequent co-occurrence and underrepresentation in rhythm-control studies.We evaluated real-world outcomes associated with catheter ablation among patients with SUD and AF or AFL.

Methods

We conducted a retrospective cohort study of adults with SUD and AF or AFL. Patients were stratified by catheter ablation exposure. The primary outcome was all-cause mortality at 1 year. Secondary outcomes included all-cause hospitalization, heart failure hospitalization, incident heart failure, cerebrovascular events, and outpatient follow-up. Multivariable logistic regression adjusted for baseline comorbidity.