Procedural Parameters in Predicting Late Recurrence Following Catheter Ablation of Paroxysmal Atrial Fibrillation

Background: To investigate the predictive value of catheter ablation parameters during pulmonary vein isolation (PVI) on long-term recurrence in patients with paroxysmal atrial fibrillation (pAF). Methods: A retrospective analysis was conducted on 386 pAF patients who underwent initial catheter-based radiofrequency ablation (RFA) for PVI. After excluding ineligible cases and those lost to follow-up, 150 patients were included (mean follow-up: 28.86 ± 3.03 months). Patients were divided into recurrence and AF-free groups. Ablation parameters including catheter contact force (CF), ablation index (AI), and GAPs were collected via the CARTO VISITAG Module, and Cox regression was used to identify recurrence predictors. Results: The 2-year AF recurrence rate was 13.33% (20/150). No significant differences in baseline clinical characteristics, AI compliance rate, VISITAG GAP incidence, ablation points and time, or complication rates were observed between groups (p > 0.05). However, CF compliance rate was significantly lower in the AF recurrence group compared to AF-free group (79.17% vs. 90.10%, p < 0.001), and it was an independent predictor of late AF recurrence (HR = 0.950, 95%CI: 0.919-0.981; p = 0.002). Conclusion: CF compliance rate is independently associated with late AF recurrence after PVI. Maintaining stable CF during ablation may promote durable lesions and potentially reduce recurrence risk.