Predictors of Early Versus Late Atrial Tachyarrhythmia Recurrence After Cryoballoon Ablation by Atrial Fibrillation
Jinsun Park1,2, Myung-Jin Cha1,3, Chang Hee Kwon4
1Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Introduction:
Patient characteristics and predictors of early (ERAT) and late (LRAT) recurrence of atrial tachyarrhythmia by atrial fibrillation (AF) type after cryoballoon ablation (CBA) remain poorly defined.
Methods:
Using the Korean Heart Rhythm Cryoballoon Registry (12 centers, 2018-2022), 2051 patients undergoing CBA for drug-refractory AF were stratified by AF type. ERAT was defined as atrial tachyarrhythmia within the 3-month blanking period and LRAT as recurrence beyond 3 months. Independent predictors of ERAT (all patients) and LRAT (patients without ERAT) were identified.
Results:
ERAT occurred in 631 patients (30.8%; 17.6% in paroxysmal and 40.4% in persistent AF). Among 1420 patients without ERAT, LRAT occurred in 311 (21.9%; 16.7% paroxysmal, 27.2% persistent). In paroxysmal AF, coronary artery disease (HR 1.60; 95% CI, 1.00-2.56; p = 0.048) and LA enlargement (HR 1.07; 95% CI, 1.04-1.10; p < 0.001) predicted ERAT, whereas hypertrophic cardiomyopathy (HR 5.01; 95% CI, 2.20-11.42; p < 0.001) and LA enlargement (HR 1.04; 95% CI, 1.01-1.08; p = 0.019) predicted LRAT. In persistent AF, AF duration (HR 1.04; 95% CI, 1.02-1.06; p < 0.001) and LA enlargement (HR 1.03; 95% CI, 1.02-1.04; p < 0.001) predicted ERAT, and LA enlargement (HR 1.03; 95% CI, 1.01-1.05; p = 0.010) independently predicted LRAT.
Conclusion:
Predictors of ERAT and LRAT differed between patients with paroxysmal and those with persistent AF. LA enlargement was the most consistently shared predictor across recurrence phenotypes.
Related Concept Videos
Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Dysrhythmias II: Classification of Tachyarrhythmias
Mechanism of Cardiac Arrhythmias
Dysrhythmias III: Characteristics of Dysrhythmias
Dysrhythmias IV: Characteristics of Bradyarrhythmias


