Arrhythmias & electrophysiology
Catheter ablation for persistent atrial fibrillation: patterns of recurrence and impact on quality of life and health care utilization
Authors' conclusion
AF recurrence is more often paroxysmal after catheter ablation for PsAF irrespective of ablation strategy. Recurrent PsAF was associated with higher AF burden, increased healthcare utilization and antiarrhythmic drug use.
Study context
- Population
- Patients with symptomatic persistent AF (PsAF) randomised to PVI plus posterior wall isolation or PVI alone
- Participants
- 333 patients
- Comparison
- PsAF recurrence vs paroxysmal AF (PAF) recurrence vs no recurrence after ablation for PsAF
- PsAF recurrencen = 57
- PAF recurrencen = 97
- Primary endpoint
- Pattern of AF recurrence after catheter ablation for PsAF
- Follow-up
- 12 months
Methodological detailsinternational, multicentre, Rhythm monitoring by twice-daily single-lead ECG, implantable device or 3-monthly Holter
- International
- Multicentre
- Rhythm monitoring by twice-daily single-lead ECG, implantable device or 3-monthly Holter
Primary result
As reported in the abstract
- Any atrial fibrillation (AF) recurrence
- 154 of 333 (46.2%)
- Recurrence type did not differ between randomisation groups
- P = 0.508
Further findings
Healthcare utilisation — PsAF recurrence vs PAF recurrence
P < 0.001
| Outcome | PsAF recurrence | PAF recurrence | No recurrence | P value |
|---|---|---|---|---|
| Median AF burdenPsAF recurrence vs PAF recurrence | 27.4% | .9% | — not stated in the abstract | P < 0.001 |
| Baseline LVEFPsAF recurrence vs PAF recurrence | 50% | 60% | — not stated in the abstract | P < 0.001 |
| Left atrial volumePsAF recurrence vs PAF recurrence | 54.2 (SD 19.3) mL/m² | 44.8 (SD 11.6) mL/m² | — not stated in the abstract | P = 0.008 |
| Healthcare utilisationNo recurrence · lowest without recurrence | P < 0.001 | |||
| Change in AFEQT QoL scoreNo recurrence vs PAF recurrence · mean change, points | 13.4 (SD 22.9) | 24.0 (SD 25.0) | 33.3 (SD 25.2) | P = 0.012 |
| Change in AFEQT QoL scoreNo recurrence vs PsAF recurrence | P < 0.001 |
— not stated in the abstract
Original publication
Catheter ablation for persistent atrial fibrillation: patterns of recurrence and impact on quality of life and health care utilization. Eur Heart J. Published 17 May 2024. doi:10.
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