Delayed recurrence of atrial fibrillation 2years after catheter ablation is associated with metabolic syndrome

Abstract

Background: Whether delayed clinical recurrence of atrial fibrillation (AF) 2years after radiofrequency catheter ablation (CR_>2-years) is related to AF progression remains unclear.

Objective: We hypothesized that metabolic factors are associated with CL_>2-years.

Methods: Among 1825 patients who underwent catheter ablation, the study included 523 patients with AF recurrence (27.2% women, mean age 57±11years, 58.3% paroxysmal AF) 3months after the ablation procedure. They were divided into the clinical recurrence within 2-years (CL_≤2-years: AF recurrence at 3-24months) and CL_>2-years (AF recurrence >24months) groups. Clinical and imaging parameters and polysomnograms were compared.

Results: Over 42±19months of follow-up, 409 (78.2%) and 114 (21.8%) patients formed the CL_≤2-years and CL_>2-years groups, respectively. The CL_>2-years group had higher proportions of overweight (p=0.004), hypertension (p=0.049), diabetes mellitus (p=0.037), dyslipidemia (p=0.009), high sensitivity C-reactive protein >8mg/L (p=0.049), and metabolic syndrome (p=0.011) than the CL_≤2-years group. Despite no significant difference between the apnea and hypopnea indices in the CL_≤2-years (n=97) and CL_>2-years (n=28) groups, the minimum peripheral oxygen saturation was significantly lower in the latter than the former (p=0.032). In the multivariate analysis, overweight (odds ratio [OR] 1.756, 95% confidence interval [CI] 1.146-2.693, p=0.010), dyslipidemia (OR 1.587, 95% CI 1.033-2.438, p=0.035), and metabolic syndrome (OR 1.972, 95% CI 1.158-3.356, p=0.012) were independently associated with CL_>2-years.

Conclusions: Overweight, dyslipidemia, and metabolic syndrome are independent predictors of CL_>2-years for AF after catheter ablation. CL_>2-years seems to be affected by metabolic factors and can be related to AF progression.

Keywords: Atrial fibrillation; Catheter ablation; Overweight; Progression; Recurrence.