Long duration of radiofrequency energy delivery is an independent predictor of clinical recurrence after catheter ablation of atrial fibrillation: over 500 cases experience.
BACKGROUND
Although radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) is an effective rhythm control strategy, there is a substantial amount of recurrence. We explored the predictors of AF recurrence after RFCA with consistent ablation strategy.


RESULTS
This study included 575 patients (77% male, 56 ± 11 years old) with AF (65.7% paroxysmal AF [PAF], 34.3% persistent AF [PeAF]) who underwent RFCA. We evaluated the clinical, serological, and electrophysiological parameters thereof.


RESULTS
1. During 15 ± 7 months of follow-up, patients who experienced AF recurrence (21.8%) were older (58 ± 10 vs. 55 ± 11 years old, p=0.019) and more likely to have PeAF (50.4% vs. 29.4%, p<0.001) and greater LA volume (137.3 ± 49.1 vs. 116.6 ± 37.9 mL, p<0.001). 2. In patients with clinical recurrence after RFCA, both ablation time (110.1 ± 43.8 vs. 92.3 ± 30.1 min, p<0.001) and procedure time (222.7 ± 79.6 vs. 205.8 ± 58.8 min, p<0.001) were prolonged, and the early recurrence rate within 3 months of the procedure was higher (63.0% vs. 26.4%, p<0.001) than those without clinical recurrence. 3. In logistic regression analysis, LA volume (OR 1.008, CI 1.001-1.014), ablation time (per quartile, OR 1.380, CI 1.031-1.847), and early recurrence (OR 3.858, CI 2.420-6.150) were independent risk factors for recurrence of AF after RFCA.


CONCLUSIONS
In this single center consistent study of over 500 cases of AF ablation, patients with AF recurrence had a larger atrium, longer ablation time, and a higher chance of early recurrence than those remained in sinus rhythm. Inadvertent, long duration of ablation was an independent predictor of worse clinical outcomes after catheter ablation of AF.
Yonsei University Health System, Seoul, Republic of Korea.
Jaemin
J
Shim
Boyoung
B
Joung
Jae Hyung
JH
Park
Jae-Sun
JS
Uhm
Moon-Hyoung
MH
Lee
Hui-Nam
HN
Pak
D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome