Related Experiment Video
Updated: Dec 13, 2025
Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
Published on: May 26, 2015
Predictors of recurrence of atrial fibrillation within the first 3 months after ablation
Matthias Daniel Zink1,2, Winnie Chua3, Stef Zeemering2
1Department of Internal Medicine I, University Hospital RWTH Aachen, Aachen, Germany.
Insights
Early atrial fibrillation (AF) recurrence post-ablation is common, with half of cases occurring within 14 days. Vascular disease and cardioversion during ablation predict AF recurrence.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Research
Background:
- Catheter ablation successfully frees 50-70% of patients from atrial fibrillation (AF) at one year.
- Early AF recurrence post-ablation, while often self-terminating, is linked to later AF persistence.
Purpose of the Study:
- To identify clinical and procedural factors predicting early atrial fibrillation recurrence after catheter ablation.
Main Methods:
- Retrospective analysis of 678 patients from the AXAFA-AFNET 5 trial, focusing on AF recurrence within 90 days post-ablation.
- Multivariable analysis to assess predictors including history of stroke/TIA, coronary artery disease, cardioversion during ablation, and age:sex interaction.
- Evaluation of P-wave duration at follow-up in patients with and without AF recurrence.
Main Results:
- 28% of patients experienced recurrent AF within 90 days, with 48% of these events occurring within the first 14 days.
- History of stroke/TIA, coronary artery disease, cardioversion during ablation, and older age in women were associated with increased AF recurrence risk.
- Patients with recurrent AF showed significantly longer P-wave duration at follow-up (129 ms vs. 122 ms).
Conclusions:
- Half of early AF recurrences post-ablation happen within the first two weeks.
- Vascular disease and intra-procedural cardioversion are significant predictors of recurrent atrial fibrillation.
- Increased P-wave duration at follow-up is associated with AF recurrence.
Aims:
Freedom from atrial fibrillation (AF) at 1 year can be achieved in 50-70% of patients undergoing catheter ablation. Recurrent AF early after ablation most commonly terminates spontaneously without further interventional treatment but is associated with later recurrent AF. The aim of this investigation is to identify clinical and procedural factors associated with recurrence of AF early after ablation.
Methods And Results:
We retrospectively analysed data for recurrence of AF within the first 3 months after catheter ablation from the randomized controlled AXAFA-AFNET 5 trial, which demonstrated that continuous anticoagulation with apixaban is as safe and as effective compared to vitamin K antagonists in 678 patients undergoing first AF ablation. The primary outcome of first recurrent AF within 90 days was observed in 163 (28%) patients, in which 78 (48%) patients experienced an event within the first 14 days post-ablation. After multivariable adjustment, a history of stroke/transient ischaemic attack [hazard ratio (HR) 1.54, 95% confidence interval (CI) 0.93-2.6; P = 0.11], coronary artery disease (HR 1.85, 95% CI 1.20-2.86; P = 0.005), cardioversion during ablation (HR 1.78, 95% CI 1.26-2.49; P = 0.001), and an age:sex interaction for older women (HR 1.01, 95% CI 1.00-1.01; P = 0.04) were associated with recurrent AF. The P-wave duration at follow-up was significantly longer for patients with AF recurrence (129 ± 31 ms vs. 122 ± 22 ms in patients without AF, P = 0.03).
Conclusion:
Half of all early AF recurrences within the first 3 months post-ablation occurred within the first 14 days post-ablation. Vascular disease and cardioversion during the procedure are strong predictors of recurrent AF. P-wave duration at follow-up was longer in patients with recurrent AF.
Trial Registration:
Clinicaltrials.gov identifier NCT02227550.
Related Concept Videos
01:29Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias