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Early Recurrence after Longstanding Persistent Atrial Fibrillation Ablation.

Kei Takayama1, Hitoshi Hachiya2, Yoshito Iesaka2

  • 1Department of Cardiovascular Medicine, Tokyo Medical and Dental University.

International Heart Journal
|March 23, 2018
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Early recurrence of atrial fibrillation (AF) after ablation is common. A 15-day blanking period is optimal, as patients with recurrence within this time had better outcomes than those with later recurrence.

Keywords:
Catheter ablationEarly Recurrence

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Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Early recurrence (ER) of atrial fibrillation (AF) is frequent after catheter ablation for longstanding persistent AF.
  • Optimal timing for repeat ablation remains undetermined.

Purpose of the Study:

  • To determine the optimal blanking period for early recurrence after catheter ablation of longstanding persistent AF.
  • To identify predictors of early recurrence and treatment failure.

Main Methods:

  • Two hundred four patients with longstanding persistent AF underwent catheter ablation.
  • Early recurrence was defined as AF within 60 days post-procedure.
  • Patients were analyzed based on the timing of their first recurrence (ER ≤ 15 days vs. ER16-60 days).

Main Results:

  • Early recurrence occurred in 56.4% of patients within 9 days.
  • A 15-day blanking period was found to be optimal.
  • Patients with ER ≤ 15 days had significantly lower rates of protocol-defined treatment failure (PDTF) compared to those with ER16-60 days (60.0% vs. 20.0%, P < 0.0001).
  • AF duration and left atrial diameter predicted ER16-60.

Conclusions:

  • A 15-day blanking period is recommended after catheter ablation for longstanding persistent AF.
  • Early recurrence within 15 days is associated with better long-term outcomes than later recurrence.
  • AF duration and left atrial diameter are key predictors for recurrence timing.