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

Hee Tae Yu1, In-Soo Kim1, Tae-Hoon Kim1

  • 1Division of Cardiology, Yonsei University Health System, Seoul, Republic of Korea.

Journal of Cardiovascular Electrophysiology
|January 11, 2020
PubMed

Insights

Longer atrial fibrillation (AF) duration increases recurrence after catheter ablation, particularly in persistent AF cases. Paroxysmal AF duration did not significantly impact recurrence rates post-ablation.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Research

Background:

  • Longer durations of atrial fibrillation (AF) are linked to higher recurrence rates following rhythm control strategies.
  • Limited data exists on how AF duration specifically affects recurrence after atrial fibrillation catheter ablation (AFCA).
  • Understanding AF duration's impact is crucial for optimizing AFCA outcomes.

Purpose of the Study:

  • To investigate the relationship between AF duration and rhythm outcomes after AFCA.
  • To compare recurrence rates based on AF duration (≤3 years vs. >3 years) and AF burden (paroxysmal vs. persistent).

Main Methods:

  • A cohort of 1005 patients undergoing AFCA with evident first ECG diagnosis time points was analyzed.
  • Patients were stratified by AF duration (≤3 years vs. >3 years) and AF burden (paroxysmal atrial fibrillation [PAF] vs. persistent atrial fibrillation [PeAF]).
  • Clinical characteristics and rhythm outcomes were compared during a mean follow-up of 24 months.

Main Results:

  • Longer AF durations were associated with older age, larger left atrial size, and higher prevalence of hypertension and PeAF.
  • A significantly higher postablation clinical recurrence rate was observed in patients with longer AF durations (logrank P=.002).
  • AF recurrence was significantly higher in PeAF patients with >3 years of AF duration (P=.009), but not in PAF patients (P=.939).

Conclusions:

  • Longer AF duration is associated with increased clinical recurrence rates after AFCA.
  • This association is significant for persistent AF (PeAF) patients with durations exceeding 3 years.
  • AF duration does not appear to significantly influence recurrence rates in paroxysmal AF (PAF) patients post-ablation.
Abstract

Keywords:
atrial fibrillationcatheter ablationdurationpersistentrecurrence

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