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. 2020 Nov;31(11):2898-2906.
doi: 10.1111/jce.14749. Epub 2020 Oct 1.

Incidence and clinical impact of early recurrence of atrial tachyarrhythmia after surgical ablation for atrial fibrillation

Jin Hee Choi  1 , Ki Won Hwang  1 , Soon Myung Jung  1 , Soo Yong Lee  1 , Sang Hyun Lee  1 , Min-Ku Chon  1 , Jeong-Su Kim  1 , Hyung Gon Je  2 , Yong-Hyun Park  1 , June Hong Kim  1 , Sang Kwon Lee  2 , Kook Jin Chun  1
Affiliations

Incidence and clinical impact of early recurrence of atrial tachyarrhythmia after surgical ablation for atrial fibrillation

Jin Hee Choi et al. J Cardiovasc Electrophysiol. 2020 Nov.

Abstract

Background: Atrial tachyarrhythmias (ATAs) are common within the 3-month blanking period after catheter ablation of atrial fibrillation (AF). However, little evidence is available regarding the current guidelines on the blanking period after surgical AF ablation. We investigate the incidence and significance of early recurrence of atrial tachyarrhythmia (ERAT) and evaluate the optimal blanking period after surgical AF ablation.

Methods: Data from 259 patients who underwent surgical AF ablation from 2009 to 2016 were collected. ERAT was defined as documented ATA episodes lasting for 30 s. A multivariate Cox proportional hazard model was constructed to evaluate the role of ERAT as a predictor of late recurrences (LR) for AF.

Results: In total, 127 patients (49.0%) experienced their last episodes of ERAT during the first (n = 65), second (n = 14), or third (n = 48) month of the 3-month blanking period (p < .001). One year freedom from ATAs was 97.8% in patients without ERAT compared with 95.4%, 64.3%, and 8.3% in patients with ERAT in the first, second, and third months after the index procedure, respectively (p < .001). Hazard ratios of LR according to the timing of the last episode of ERAT first, second, and third months after the procedure were 2.84, 16.70, and 119.75, respectively.

Conclusions: The ERAT occurred in 49.0% of patients within the first 3 months after surgical ablation. The occurrence of ERAT within 3 months after surgical AF ablation was a significant independent predictor of LR. Hence, the currently accepted 3-month blanking period may be considered for redefining in patients with AF surgical ablation.

Keywords: ablation; atrial fibrillation; atrial tachyarrhythmia; blanking period; cardiac surgery.

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  • When should I worry? When should I be happy?
    Churyla A. Churyla A. J Cardiovasc Electrophysiol. 2020 Nov;31(11):2907-2908. doi: 10.1111/jce.14747. Epub 2020 Sep 28. J Cardiovasc Electrophysiol. 2020. PMID: 32945046 No abstract available.

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