Very-Early Recurrence Burden of Atrial Tachyarrhythmias After Atrial Fibrillation Ablation Predicts Late Recurrence

Very-early recurrence of atrial tachyarrhythmia (VERAT) is common after atrial fibrillation (AF) radiofrequency ablation. The association between the burden of VERAT and late recurrence of atrial tachyarrhythmia (LRAT) has not been fully studied.

Consecutive patients who underwent index AF ablation from September 1, 2020, to August 31, 2023, were enrolled. VERAT was defined as any recurrent atrial tachyarrhythmias within the first 7 days after ablation. All patients were followed up for 12 months. VERAT patients were classified into three groups by cutoff value based on receiver operating characteristic (ROC) curve analysis: without-VERAT, low VERAT burden (< 18.17%), and high VERAT burden (≥ 18.17%). The association between VERAT burden and LRAT was analyzed by Cox regression model.

VERAT occurred in 137 of the 503 patients (27.2%). LRAT was observed in 53 patients (10.5%). VERAT burden was higher among LRAT patients. ROC curve revealed a correlation between VERAT burden and LRAT (area under curve 0.654, 95% confidence interval [95% CI] 0.566-0.741, p < 0.001). Compared with without-VERAT group and low VERAT burden group, patients in high VERAT burden group were related to a 5.3-fold (hazard ratio [HR] 5.307, 95% CI 2.909-9.683, p < 0.001) and 3.3-fold (HR 3.276, 95% CI 1.471-7.293, p = 0.004) LRAT risk, respectively. Both VERAT (HR 3.001, 95% CI 1.748-5.154, p < 0.001) and VERAT burden (HR 1.024 per 1% increase, 95% CI 1.014-1.034, p < 0.001) were predictors of LRAT.

VERAT and its burden were associated with an increased risk of LRAT in AF patients who underwent radiofrequency ablation.