title: Predictors of early and late recurrence of atrial fibrillation after catheter ablation of paroxysmal atrial fibrillation.
abstract: BACKGROUND
  The outcome of patients with early recurrence of atrial fibrillation (AF) (within one month) after ablation procedure is controversial. Furthermore, the predictors of early and late (up to mean follow-up 30 months) recurrence of AF are not investigated in depth.
  
  
  OBJECTIVE
  The aim of the present study was to investigate the predictors of early and late recurrence of AF after catheter ablation of arrhythmogenic foci initiating AF in patients with paroxysmal AF.
  
  
  RESULTS
  The study included 207 patients (155 men; mean age 62 +/- 13 years) who received catheter ablation of paroxysmal AF. Eighty-one (39%) patients had early recurrence of AF. Five clinical variables were related to the early recurrence of AF: (1) old age (>/=65 years) ( P = 0.004); (2) presence of associated cardiovascular disease ( P = 0.01); (3) presence of multiple AF foci ( P = 0.004); (4) presence of AF foci from left atrial free wall ( P = 0.039); (5) left atrial enlargement ( P = 0.038). Multivariate analysis demonstrated that presence of multiple AF foci could predict early recurrence of AF ( P = 0.013; ratio = 2.24; 95% CI 1.18 to 4.25). During the follow-up period (30 +/- 11 months), 70 (34%) patients had late recurrence of AF, and two clinical variables were related to the late recurrence of AF: (1) presence of early recurrence of AF ( P = 0.025); (2) presence of multiple AF foci ( P = 0.034). Multivariate analysis found that presence of early recurrence of AF could predict late recurrence of AF ( P = 0.046; hazard ratio = 1.62; 95% CI 1.01 to 2.59). Late recurrence of AF happened in 35 (43%) of the 81 patients with early recurrence of AF, and in 35 (28%) of the 126 patients without early recurrence of AF.
  
  
  CONCLUSIONS
  Early AF recurrence could predict late AF recurrence.
authors.affiliation: Department of Medicine, School of Medicine, National Yang-Ming University, and Fu Jen Catholic University, Division of Cardiology, Veterans General Hospital-Taipei, and Shin Kong Wu Ho-Su Memorial Hospital, Taiwan, Republic of China. ufae0061@ms7.hinet.net
authors.forename: Shih-Huang
authors.initials: SH
authors.lastname: Lee
authors.forename: Ching-Tai
authors.initials: CT
authors.lastname: Tai
authors.forename: Ming-Hsiung
authors.initials: MH
authors.lastname: Hsieh
authors.forename: Chin-Feng
authors.initials: CF
authors.lastname: Tsai
authors.forename: Yung-Kuo
authors.initials: YK
authors.lastname: Lin
authors.forename: Hsuan-Ming
authors.initials: HM
authors.lastname: Tsao
authors.forename: Wen-Chung
authors.initials: WC
authors.lastname: Yu
authors.forename: Jin-Long
authors.initials: JL
authors.lastname: Huang
authors.forename: Kow-Chang
authors.initials: KC
authors.lastname: Ueng
authors.forename: Jun-Jack
authors.initials: JJ
authors.lastname: Cheng
authors.forename: Yu-An
authors.initials: YA
authors.lastname: Ding
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
mesh_terms: D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation; D015716:Electrocardiography, Ambulatory; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011667:Pulmonary Veins / Q000473:pathology / Q000601:surgery; D012008:Recurrence; D013318:Stroke Volume / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000473:pathology / Q000601:surgery