Long Atrial Fibrillation Duration and Early Recurrence Are Reliable Predictors of Late Recurrence after Radiofrequency Catheter Ablation

2022 ◽  
Author(s):  
Zhitong LI ◽  
Shihao Wang ◽  
Tesfaldet Hidru ◽  
Yuanjun Sun ◽  
Lianjun Gao ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Late Recurrence ◽  
Early Recurrence ◽  
Atrial Fibrillation Duration

scholarly journals Outcome of contact force-guided radiofrequency catheter ablation or second generation cryoballoon ablation for paroxysmal atrial fibrillation: propensity score matched analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Ukita ◽  
A Kawamura ◽  
H Nakamura ◽  
K Yasumoto ◽  
M Tsuda ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Propensity Score ◽  
Contact Force ◽  
Paroxysmal Atrial Fibrillation ◽  
Radiofrequency Catheter Ablation ◽  
Second Generation ◽  
Late Recurrence ◽  
Cryoballoon Ablation ◽  
Atrial Tachyarrhythmia

Abstract Background Little has been reported on the outcome of contact force (CF)-guided radiofrequency catheter ablation (RFCA) and second generation cryoballoon ablation (CBA). Purpose The purpose of this study was to compare the outcome of CF-guided RFCA and second generation CBA for paroxysmal atrial fibrillation (PAF). Methods We enrolled the consecutive 364 patients with PAF who underwent initial ablation between September 2014 and July 2018 in our hospital. We compared the late recurrence of atrial tachyarrhythmia more than three months after ablation between RFCA group and CBA group. All RFCA procedures were performed using CF-sensing catheter and all CBA procedures were performed using second generation CB. Results There were significant differences in background characteristics: chronic kidney disease, serum brain natriuretic peptide level, and left ventricular ejection fraction. After propensity score matched analysis (Table), atrial tachyarrhythmia free survival was significantly higher in CBA group than in RFCA group (Figure). Conclusions Second generation CBA showed a significantly lower late recurrence rate compared to CF-guided RFCA. Kaplan-Meier Curve Funding Acknowledgement Type of funding source: None

Abstract 13597: Association Between Antiarrhythmic Drug Therapy Prescription in the Blanking Period and Recurrent Atrial Arrhythmias After First-time Catheter Ablation for Atrial Fibrillation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Chaitanya L Malladi ◽  
Michael Eskander ◽  
Florentino Lupercio ◽  
Frederick Han ◽  
Kurt S Hoffmayer ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Late Recurrence ◽  
Early Recurrence ◽  
Limited Data ◽  
Antiarrhythmic Drug Therapy ◽  
Reduce Risk ◽  
Artery Disease ◽  
First Time ◽  
Multivariable Adjustment

Introduction: Antiarrhythmic drugs (AAD) are often prescribed in the blanking period (BP) after catheter ablation of atrial fibrillation (AF) to reduce risk of early recurrence (ER) and late recurrence (LR). There are limited data on which AAD to use during the BP. Hypothesis: We hypothesize that specific AADs may be associated with reduced risk of ER and/or LR after ablation. Methods: A total of 478 consecutive patients (mean age 64.2 years, 67.2% male) undergoing first-time pulmonary vein isolation (PVI) ablation at a single institution were included. Outcomes of interest were: freedom from ER, freedom from LR, initial discontinuation of AAD less than 90 days after ablation, and freedom from second ablation. ER was defined as AF, atrial flutter (AFL), or atrial tachycardia (AT) > 30 seconds within the BP. LR was defined as AF/AFL/AT > 30 seconds occurring after the BP. Results: Of 478 patients, 14.9% (n = 71) were on no AAD, 26.4% (n = 126) were on propafenone/flecainide, 34.5% (n = 165) were on sotalol/dofetilide, 10.7% (n = 51) were on dronedarone, and 13.6% (n = 65) were on amiodarone. Patients on amiodarone were older, had higher BMI, and were more likely to have persistent AF, hypertension, diabetes, heart failure, and coronary artery disease. In unadjusted analyses, there were no differences between groups with regards to the risk of ER (log rank P = 0.171), discontinuation of AAD before ninety days post-ablation (log rank P = 0.235), or freedom from second ablation (log rank P = 0.147). After multivariable adjustment, patients on amiodarone or dronedarone were more likely to experience LR than those on no AAD [Adjusted Hazard Ratio (AHR) 1.83, 95% CI 1.10-3.04, p=0.02 for amiodarone; AHR 1.79, 95% CI 1.05-3.05, p=0.03 for dronedarone]. Conclusions: Following first-time AF catheter ablation, there were no differences between the presence or absence of AAD and risk of ER, while those prescribed amiodarone or dronedarone in the BP were more likely to experience LR than those on no AAD.

scholarly journals Incidence and risk factors for very late recurrence of atrial fibrillation after radiofrequency catheter ablation

EP Europace ◽  
2013 ◽  
Vol 15 (11) ◽  
pp. 1581-1586 ◽  
Author(s):  
Y. Sotomi ◽  
K. Inoue ◽  
N. Ito ◽  
R. Kimura ◽  
Y. Toyoshima ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Late Recurrence

scholarly journals Predictors of early and late recurrence of atrial fibrillation after catheter ablation: two sides of the same coin?

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M Ribeiro Da Silva ◽  
G Santos Silva ◽  
P Ribeiro Queiros ◽  
R Teixeira ◽  
J Almeida ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Logistic Regression ◽  
Catheter Ablation ◽  
Independent Predictor ◽  
Late Recurrence ◽  
Early Recurrence ◽  
Multivariate Logistic Regression ◽  
Funding Sources ◽  
Early And Late Recurrence ◽  
Af Recurrence

Abstract Background Recurrence of atrial fibrillation (AF) after catheter ablation (CA) is estimated to be between 20% and 45%. Recurrent AF early after ablation is generally classified as benign as a part of a blanking period, but recently has been associated with later recurrent AF. The prediction of early and late AF recurrence after CA remains challenging as well as the predictive value of early AF recurrence in the blanking period. Purpose We aimed to determine the clinical and procedural factors associated with early and late recurrence of AF after CA. Methods Single-centre retrospective study that included all patients who underwent AF CA between January 2017 and October 2019. Ablation procedures included radiofrequency and second-generation cryoballoon CA. Early recurrence of AF (ERAF) was defined as any recurrence of AF >30 seconds within 90 days after CA and late recurrence (LR) was defined as any recurrence of AF >30 seconds after 90 days of CA. The independent association between clinical and procedural variables and AF recurrence was evaluated with logistic regression analysis. Results We included 399 patients, 64,7% male, with a mean age of 56,8±11,6 years, most of them had paroxysmal AF with a mean duration until CA of 3,5±3,4 years. Early recurrence of AF occurred in 51 patients (12,8%). After multivariate logistic regression, we identify left atrium (LA) diameter [odds ratio (OR) 1,1, 95% confidence interval (CI) 1,03–1,18; p=0,007] as the only independent predictor associated with recurrent AF. Late recurrence of AF was observed in 104 patients (26,1%), on average, 12,8±8,7 months after CA. After multivariable adjustment, LA diameter (OR 1,1, 95% CI 1,01–1,12; p=0,032) and intraprocedural electric cardioversion (OR 1,8, 95% CI 1,03–3,12; p=0,040) were independently associated with recurrent AF. Regarding patients with ERAF, most of them also had late recurrent AF (64,7%), whereas in patients without ERAF, only 20,4% had LR (p<0,001). After including ERAF in the multivariate logistic regression, we identify ERAF as the only independent predictor of late recurrence of AF (OR 5,23, 95% CI 2,56–10,72; p<0,001). Conclusions In our cohort, late recurrence of AF after catheter ablation was significantly higher in patients with recurrence within the blanking period, which was the only independent predictor of AF late recurrence. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Early arrhythmia recurrence after catheter ablation for persistent atrial fibrillation: is it predictive for late recurrence?

2021 ◽  
Author(s):  
Miruna A. Popa ◽  
Marc Kottmaier ◽  
Elena Risse ◽  
Marta Telishevska ◽  
Sarah Lengauer ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Antiarrhythmic Drugs ◽  
De Novo ◽  
Persistent Atrial Fibrillation ◽  
Late Recurrence ◽  
Early Recurrence ◽  
Transient Phenomenon ◽  
Future Studies

Abstract Background Early recurrence of atrial tachyarrhythmia (ERAT) is common after radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF), but its clinical significance in patients with persistent AF remains unclear. We sought to determine the predictive value of ERAT for rhythm outcome after RFCA for persistent AF. Methods The study included 207 consecutive patients (mean age 66.4 ± 10.7 years, male 66.2%) with persistent and long-standing persistent AF undergoing de novo pulmonary vein isolation (± atrial substrate ablation). All patients remained off antiarrhythmic drugs. ERAT was defined as any atrial arrhythmia ≥ 30 s occurring within the first 30 days. Late recurrence (LR) was determined during follow-up visits scheduled 1, 3, 6 and 12 months post-ablation using 7-day Holter ECGs. Results ERAT occurred in 143/207 (69.1%) patients as AF (60%) or atrial tachycardia (40%) and was persistent in 82% of cases. During a median follow-up of 22.2 months, LR occurred significantly more often in patients with ERAT than in patients without ERAT (92.3 vs. 43.8%, P < 0.001). The only independent predictors for LR were ERAT (OR 16.8, 95% CI 6.184–45.797, P < 0.001) and intraprocedural termination to sinus rhythm (OR 0.052, 95% CI 0.003–0.851, P = 0.038). Extending the blanking period from 30 to 90 days did not impact LR rates. Conclusion ERAT following ablation of persistent AF is strongly associated with late arrhythmia recurrence, which challenges the assumption that ERAT represents merely a transient phenomenon. While limiting the blanking period to 30 days seems justified, the benefit of early re-ablations remains to be addressed in future studies. Graphic abstract

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