Arrhythmias & electrophysiologyCohort study
Clinical, histologic, and molecular associations of early and late recurrence after thoracoscopic ablation for atrial fibrillation
- prospective enrollment
- histologic and bulk RNA-sequencing analyses of the excised left atrial appendage
Authors' conclusion
After thoracoscopic AF ablation, ER was associated with an increased risk of LR. ER occurring at 31-90 days was associated with a higher observed risk of LR than ER occurring at 0-30 days. Exploratory findings suggested differences in extracellular matrix remodeling and inflammatory signaling across recurrence patterns.
Study context
- Population
- Patients undergoing thoracoscopic ablation of advanced atrial fibrillation (AF) with concomitant left atrial appendage excision62 ± 9 years, 26.7% female
- Participants
- 449 patients
- Exposure
- Early recurrence (ER) at 0-30 days and 31-90 days compared with no ER
- ER at 0-30 daysn = 152
Main finding
As reported in the abstract
Early recurrence (any atrial tachyarrhythmia lasting >30 seconds within 90 days) · within 90 days after ablation
ER occurred in 176 of 449 patients
39.2%
of those with ER, first ER episode within 30 days
152 (86.4%)
Observational data: associations, not effects.
Further findings
| Outcome | hazard ratio | P value |
|---|---|---|
| Late recurrence (recurrence after 90 days) · 2 years rhythm surveillance — ER at 0-30 days vs no ER · higher LR risk | 1.52 | log-rank P = .002 |
| Late recurrence (recurrence after 90 days) · 2 years rhythm surveillance — ER at 31-90 days vs no ER · higher LR risk | 2.01 | log-rank P = .002 |
Proteoglycan content and late recurrence (LR) (histologic)
- Higher proteoglycan content was associated with an increased risk of LR
Bulk RNA sequencing
- Fibroinflammatory pathways were enriched in patients with ER + LR vs patients without any recurrence
Original publication
Clinical, histologic, and molecular associations of early and late recurrence after thoracoscopic ablation for atrial fibrillation. Heart Rhythm. Published 1 June 2026. doi:10.1016/j.hrthm.2026.05.045
Summarised from the published abstract; every number is checked against it