Early Recurrence Is Reliable Predictor of Late Recurrence After Radiofrequency Catheter Ablation of Atrial Fibrillation

Yun Gi Kim, Ki Yung Boo, Jong Il Choi, Yun Young Choi, Ha Young Choi, Seung Young Roh, Jaemin Shim, Jin Seok Kim, Young Hoon Kim

    Research output: Contribution to journalArticlepeer-review

    57 Citations (Scopus)

    Abstract

    Objectives: This study aimed to compare the risk of late recurrence in patients with and without early recurrence. Background: Early recurrence of atrial fibrillation (AF) or atrial tachycardia (AT) after radiofrequency catheter ablation (RFCA) in AF patients is known to be a transient phenomenon. The theoretical basis of the blanking period is based on such observations. However, the clinical implications of early recurrence need further validation. Methods: Consecutive RFCA cases in a tertiary hospital were analyzed. Early recurrence was defined as any AT or AF event occurring within 90-days post-RFCA. Early recurrence as AT and AF were also analyzed separately. Results: A total of 3,120 patients underwent RFCA. Early recurrence occurred in 751 patients (24.1%). Patients who experienced early recurrence had a larger left atrium, worse hemodynamics in the left atrial appendage, and a higher prevalence of nonparoxysmal AF and heart failure. Among patients who experienced early recurrence, 69.6% of patients eventually had late recurrence. Early recurrence was associated with a 4.3- and 3.6-fold increase in the risk of late recurrence after single and multiple procedures, respectively. After multivariate adjustment, early recurrence was an independent risk factor for late recurrence with 3.6- and 2.8-fold increase in the risk of late recurrence after single and multiple procedures, respectively. Early recurrence AT had a lower risk of late recurrence compared with early recurrence AF. Conclusions: Early recurrence was a reliable predictor for late recurrence. The clinical significance of the blanking period in the current guidelines may need to be revisited.

    Original languageEnglish
    Pages (from-to)343-351
    Number of pages9
    JournalJACC: Clinical Electrophysiology
    Volume7
    Issue number3
    DOIs
    Publication statusPublished - 2021 Mar

    Bibliographical note

    Publisher Copyright:
    © 2021 American College of Cardiology Foundation

    Keywords

    • atrial fibrillation
    • early recurrence
    • late recurrence
    • radiofrequency catheter ablation

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine
    • Physiology (medical)

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