Predictors of early and late recurrence of atrial fibrillation after catheter ablation of paroxysmal atrial fibrillation.
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.
Lee
Shih-Huang
SH
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
Tai
Ching-Tai
CT
Hsieh
Ming-Hsiung
MH
Tsai
Chin-Feng
CF
Lin
Yung-Kuo
YK
Tsao
Hsuan-Ming
HM
Yu
Wen-Chung
WC
Huang
Jin-Long
JL
Ueng
Kow-Chang
KC
Cheng
Jun-Jack
JJ
Ding
Yu-An
YA
Chen
Shih-Ann
SA
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