title: Delayed recurrence of atrial fibrillation 2years after catheter ablation is associated with metabolic syndrome.
abstract: BACKGROUND
  Whether delayed clinical recurrence of atrial fibrillation (AF) 2years after radiofrequency catheter ablation (CR>2-years) is related to AF progression remains unclear.
  
  
  OBJECTIVE
  We hypothesized that metabolic factors are associated with CL>2-years.
  
  
  METHODS
  Among 1825 patients who underwent catheter ablation, the study included 523 patients with AF recurrence (27.2% women, mean age 57±11years, 58.3% paroxysmal AF) 3months after the ablation procedure. They were divided into the clinical recurrence within 2-years (CL≤2-years: AF recurrence at 3-24months) and CL>2-years(AF recurrence >24months) groups. Clinical and imaging parameters and polysomnograms were compared.
  
  
  RESULTS
  Over 42±19months of follow-up, 409 (78.2%) and 114 (21.8%) patients formed the CL≤2-yearsand CL>2-yearsgroups, respectively. The CL>2-yearsgroup had higher proportions of overweight (p=0.004), hypertension (p=0.049), diabetes mellitus (p=0.037), dyslipidemia (p=0.009), high sensitivity C-reactive protein >8mg/L (p=0.049), and metabolic syndrome (p=0.011) than the CL≤2-yearsgroup. Despite no significant difference between the apnea and hypopnea indices in the CL≤2-years(n=97) and CL>2-years(n=28) groups, the minimum peripheral oxygen saturation was significantly lower in the latter than the former (p=0.032). In the multivariate analysis, overweight (odds ratio [OR] 1.756, 95% confidence interval [CI] 1.146-2.693, p=0.010), dyslipidemia (OR 1.587, 95% CI 1.033-2.438, p=0.035), and metabolic syndrome (OR 1.972, 95% CI 1.158-3.356, p=0.012) were independently associated with CL>2-years.
  
  
  CONCLUSIONS
  Overweight, dyslipidemia, and metabolic syndrome are independent predictors of CL>2-yearsfor AF after catheter ablation. CL>2-yearsseems to be affected by metabolic factors and can be related to AF progression.
authors.affiliation: Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Yong-Soo
authors.initials: YS
authors.lastname: Baek
authors.affiliation: Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Pil-Sung
authors.initials: PS
authors.lastname: Yang
authors.affiliation: Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Tae-Hoon
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Jae-Sun
authors.initials: JS
authors.lastname: Uhm
authors.affiliation: Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Jong-Youn
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Boyoung
authors.initials: B
authors.lastname: Joung
authors.affiliation: Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Moon-Hyoung
authors.initials: MH
authors.lastname: Lee
authors.affiliation: Yonsei University Health System, Seoul, Republic of Korea. Electronic address: hnpak@yuhs.ac.
authors.forename: Hui-Nam
authors.initials: HN
authors.lastname: Pak
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000639:trends*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000503:physiopathology; D008875:Middle Aged; D050177:Overweight / Q000453:epidemiology / Q000503:physiopathology; D017286:Polysomnography / Q000639:trends; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome
keywords: Atrial fibrillation; Catheter ablation; Overweight; Progression; Recurrence