Clinical significance of early recurrences of atrial tachycardia after atrial fibrillation ablation.
BACKGROUND
atrial tachycardia (AT) commonly recurs within 3 months after radiofrequency catheter ablation for atrial fibrillation (AF). However, it remains unclear whether early recurrence of atrial tachycardia (ERAT) predicts late recurrence of AF or AT.


METHODS
of 352 consecutive patients who underwent circumferential pulmonary vein isolation with or without linear ablation(s) for AF, 56 patients (15.9%) with ERAT were identified by retrospective analysis. ERAT was defined as early relapse of AT within a 3-month blanking period after ablation.


RESULTS
during 21.7 ± 12.5 months, the rate of late recurrence was higher in patients with ERAT (41.1%) compared with those without ERAT (11.8%, P < 0.001). In a multivariable model, positive inducibility of AF or AT immediately after ablation (65.2% vs 36.4%, P = 0.046; odd ratio, 3.9; 95% confidence interval, 1.0-14.6) and the number of patients who underwent cavotricuspid isthmus (CTI) ablation (73.9% vs 42.4%, P = 0.042; odd ratio, 4.5; 95% confidence interval, 1.1-19.5) were significantly related to late recurrence in the ERAT group. The duration of ablation (174.3 ± 62.3 vs 114.7 ± 39.5 minutes, P = 0.046) and the procedure time (329.3 ± 83.4 vs 279.2 ± 79.7 minutes, P = 0.027) were significantly longer in patients with late recurrence than in those without late recurrence following ERAT.


CONCLUSIONS
the late recurrence rate is higher in the patients with ERAT compared with those without ERAT following AF ablation, and is more often noted in the patients who underwent CTI ablation and had a prolonged procedure time. Furthermore, inducibility of AF or AT immediately after ablation independently predicts late recurrence in patients with ERAT.
Choi
Jong-Il
JI
Division of Cardiology, Department of Internal Medicine, Korea University Medical Center, Seoul, Republic of Korea Yonsei University Health System, Seoul, Republic of Korea Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Pak
Hui-Nam
HN
Park
Jae Seok
JS
Kwak
Jae Jin
JJ
Nagamoto
Yasutsugu
Y
Lim
Hong Euy
HE
Park
Sang Weon
SW
Hwang
Chun
C
Kim
Young-Hoon
YH
D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000503:physiopathology* / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013617:Tachycardia, Supraventricular / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D013997:Time Factors; D016896:Treatment Outcome