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. 2021 Mar;7(3):343-351.
doi: 10.1016/j.jacep.2020.09.029. Epub 2021 Jan 27.

Early Recurrence Is Reliable Predictor of Late Recurrence After Radiofrequency Catheter Ablation of Atrial Fibrillation

Yun Gi Kim  1 , Ki Yung Boo  1 , Jong-Il Choi  2 , Yun Young Choi  1 , Ha Young Choi  1 , Seung-Young Roh  1 , Jaemin Shim  1 , Jin Seok Kim  1 , Young-Hoon Kim  1
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Free article

Early Recurrence Is Reliable Predictor of Late Recurrence After Radiofrequency Catheter Ablation of Atrial Fibrillation

Yun Gi Kim et al. JACC Clin Electrophysiol. 2021 Mar.
Free article

Abstract

Objectives: This study aimed to compare the risk of late recurrence in patients with and without early recurrence.

Background: Early recurrence of atrial fibrillation (AF) or atrial tachycardia (AT) after radiofrequency catheter ablation (RFCA) in AF patients is known to be a transient phenomenon. The theoretical basis of the blanking period is based on such observations. However, the clinical implications of early recurrence need further validation.

Methods: Consecutive RFCA cases in a tertiary hospital were analyzed. Early recurrence was defined as any AT or AF event occurring within 90-days post-RFCA. Early recurrence as AT and AF were also analyzed separately.

Results: A total of 3,120 patients underwent RFCA. Early recurrence occurred in 751 patients (24.1%). Patients who experienced early recurrence had a larger left atrium, worse hemodynamics in the left atrial appendage, and a higher prevalence of nonparoxysmal AF and heart failure. Among patients who experienced early recurrence, 69.6% of patients eventually had late recurrence. Early recurrence was associated with a 4.3- and 3.6-fold increase in the risk of late recurrence after single and multiple procedures, respectively. After multivariate adjustment, early recurrence was an independent risk factor for late recurrence with 3.6- and 2.8-fold increase in the risk of late recurrence after single and multiple procedures, respectively. Early recurrence AT had a lower risk of late recurrence compared with early recurrence AF.

Conclusions: Early recurrence was a reliable predictor for late recurrence. The clinical significance of the blanking period in the current guidelines may need to be revisited.

Keywords: atrial fibrillation; early recurrence; late recurrence; radiofrequency catheter ablation.

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Conflict of interest statement

FUNDING SUPPORT AND AUTHOR DISCLOSURES This work was supported by a Korea University Grant (to Dr. J.I. Choi), a grant from Korea University Anam Hospital, Seoul, Republic of Korea (grant No. K1922851), and in part, by grants from the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (NRF-2015R1D1A1A02061859 to Dr. J.I. Choi), and the Ministry of Science, ICT, and Future Planning (NRF-2012R1A1A1013260 to Dr. J. I. Choi). The funders had no role in data collection, analysis, or interpretation; trial design; patient recruitment; or any aspect pertinent to the study. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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