Persistent atrial fibrillation over 3 years is associated with higher recurrence after catheter ablation

Abstract

Instruction: Longer atrial fibrillation (AF) durations have higher recurrence rates after rhythm control. However, there is limited data on the effect of the AF duration on recurrence after atrial fibrillation catheter ablation (AFCA). In the present study, we investigated the rhythm outcome of AFCA according to the AF duration based on the first electrocardiogram (ECG) diagnosis. Methods and Results:We included 1005 patients with AF (75% male, 59 ± 11 years old) who underwent AFCA and whose first ECG diagnosis time point was evident. The clinical characteristics and rhythm outcomes were compared based on the AF duration (≤3 years, n = 537; >3 years, n = 468) and AF burden (paroxysmal atrial fibrillation [PAF], n = 387; persistent atrial fibrillation [PeAF], n = 618). Longer AF durations were associated with older age (P = .020), larger left atrial size (P = .009) and a higher number of patients with hypertension (P < .001) or PeAF (P < .001). During 24 ± 22 months of follow-up, the postablation clinical recurrence rate was higher in patients with a longer AF duration (logrank P = .002). The AF recurrence rate was significantly higher in PeAF patients with an AF duration >3 years (logrank P = 0.009), but not in subjects with PAF (logrank P = .939). In a multivariate Cox regression analysis, a longer AF duration was significantly associated with a higher clinical recurrence rate after AFCA in PeAF patients (adjusted hazard ratio, 1.06; range, 1.03-0.10; P = 0.001), but not PAF.Conclusion: Although longer AF duration was associated with higher clinical recurrence rates after AFCA, the rate was significant in patients with PeAF lasting >3 years, but not in PAF patients. K E Y W O R D Satrial fibrillation, catheter ablation, duration, persistent, recurrence

The prognostic significance of left atrial appendage peak flow velocity in the recurrence of persistent atrial fibrillation following first radiofrequency catheter ablation

“…Certain variables, such as AF duration (8), body mass index (BMI) (9), high blood pressure (10), diabetes mellitus (11), left atrial (LA) diameter (12,13), LA strain (14), and other echocardiographic indexes (15,16) can play a role in predicting ablation outcomes. However, no valid parameter exists to forecast AF recurrence following ablation.…”

A mesh‐type flexible tip catheter vs a contact force catheter for catheter ablation of atrial fibrillation: A prospective nonrandomized 1:1 matched study

“…However, it still poses a continuous risk for recurrence, even after AFCA 10 . Continuous recurrence after AFCA is related to the fact that AF itself is a progressive disease, and electrical reconnections of PVs are the main cause in most cases of recurrence within a year after a procedure 21 . Notwithstanding, the rhythm outcomes for AFCA are gradually improving as a durable CPVI is now possible with the development of more efficient ablation catheter technologies 10 .…”

Association of over 3‐year duration with recurrence after catheter ablation in patients with persistent atrial fibrillation

“…We read with great interest the recent article by Hee et al, 1 and would like to congratulate the authors for this landmark study in recurrent atrial fibrillation (AF) after ablation. This research provides important initial evidence for the association of longer AF duration with higher recurrence rate after catheter ablation in patients with persistent AF (PeAF).…”