Predictors of very late recurrence of atrial fibrillation after circumferential pulmonary vein ablation.
BACKGROUND
Early recurrence of atrial fibrillation (ERAF) after catheter ablation is common and has been thoroughly studied. However, very late recurrence of atrial fibrillation (VLRAF) is rarely researched, and its characteristics have not been determined.


OBJECTIVE
The aim of this study was to investigate the clinical characteristics of VLRAF after circumferential pulmonary vein ablation (CPVA), and to identify the risk factors for VLRAF.


METHODS
We retrospectively studied 259 consecutive patients with atrial fibrillation (AF) who were referred for CPVA. Clinical variables were investigated and predictors of VLRAF were identified.


RESULTS
A total of 249 patients were enrolled in this study. After a mean follow-up of 18.2 +/- 4.4 mo, 14 patients (5.6%) had VLRAF. Patients with VLRAF were more likely than those without recurrence to have ERAF (78.6% versus 17.8%, p = 0.000) and persistent AF (50.0% versus 13.0%, p = 0.000), but were less likely to achieve pulmonary vein (PV) isolation (78.6% versus 97.6%, p = 0.000). Bivariate analysis demonstrated that ERAF (odds ratio [OR] 8.148, 95% confidence interval [CI] 2.197-30.222; p = 0.002), persistent AF (OR 8.853, 95% CI 1.773-16.155; p = 0.003), and lack of PV isolation (OR 7.530, 95% CI 1.792-33.122; p = 0.006) were related to VLRAF. Multivariate logistic regression analysis only identified ERAF as a predictor of VLRAF after CPVA (OR 7.461, 95% CI 1.696-24.836; p = 0.006).


CONCLUSIONS
Very late recurrence of AF is uncommon after CPVA. That occurs more commonly in patients with ERAF.
Department of Cardiology, Beijing AnZhen Hospital, Capital Medical University, Beijing, China. chshma@vip.sina.com
Hailong
H
Tao
Xingpeng
X
Liu
Jianzeng
J
Dong
Deyong
D
Long
Ribo
R
Tang
Bin
B
Zheng
Junping
J
Kang
Ronghui
R
Yu
Ying
Y
Tian
Changsheng
C
Ma
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000601:surgery*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000294:innervation / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult