Predictive value of early atrial tachyarrhythmias recurrence after circumferential anatomical pulmonary vein ablation.
OBJECTIVE
Radiofrequency (RF) ablation at the ostia of the pulmonary veins (PVs) to cure atrial fibrillation (AF) is often followed by early AF recurrence. The aims of this study were to determine the rate of early atrial tachyarrhythmia as recurrence after circumferential anatomical PV ablation; to evaluate whether the early recurrence of atrial tachyarrhythmias correlates with the long-term outcome of ablation; and to identify the predictors of early atrial tachyarrhythmias relapse.


METHODS
We studied 143 consecutive patients who underwent circumferential anatomical PV ablation. We defined early atrial tachyarrhythmias relapse as the recurrence of atrial tachyarrhythmias during the first 3 months after RF ablation.


RESULTS
After a mean follow-up of 18.7 +/- 7.2 months, 102/143 patients (71%) were deemed responders to ablation. Atrial tachyarrhythmias relapsed during the first 3 months of follow-up in 65/143 (46%) patients. Patients without early atrial tachyarrhythmias relapse had a higher probability of long-term clinical success than patients with early atrial tachyarrhythmias relapse (95% vs 43%, P < 0.0001). However, patients who relapsed within the first month had 45.5% probability of long-term clinical success. On multivariate analysis, the presence of structural heart disease and the lack of a successful anatomical ablation of all targeted PV were significantly and independently correlated with early atrial tachyarrhythmias relapse.


CONCLUSIONS
A delayed cure may be expected in almost 50% of patients in whom atrial tachyarrhythmias relapses within the first month after circumferential anatomical PV ablation. The presence of structural heart disease and the lack of a successful anatomical ablation of all targeted PV predict early atrial tachyarrhythmias recurrence.
Bertaglia
Emanuele
E
Dipartimento di Cardiologia, Ospedale Civile di Mirano (VE), Italy. cardiologia.mirano@ulss13mirano.ven.it
Stabile
Giuseppe
G
Senatore
Gaetano
G
Zoppo
Franco
F
Turco
Pietro
P
Amellone
Claudia
C
De Simone
Antonio
A
Fazzari
Massimo
M
Pascotto
Pietro
P
D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins; D012008:Recurrence; D013610:Tachycardia / Q000209:etiology*; D016896:Treatment Outcome