Arrhythmias & electrophysiology
Duration of atrial fibrillation persistence: Implications for recurrence risk after catheter ablation and efficacy of additional substrate ablation
Authors' conclusion
Whereas LsAF 1-2.4 years has similar outcomes to those of PerAF, LsAF >2.4 years was linked to higher arrhythmia recurrence risks. For LsAF >2.4 years, the PVI-plus strategy showed a potential to be superior to the PVI-alone strategy.
Study context
- Population
- Patients with persistent atrial fibrillation (AF) undergoing catheter ablation with contact force-sensing catheter
- Participants
- 458 patients
- Comparison
- Long-standing AF (LsAF) 1-2.4 years and LsAF >2.4 years vs persistent AF (PerAF) <1 year; Pulmonary vein isolation (PVI)-plus vs PVI-alone
- Primary endpoint
- Arrhythmia-free survival after a 3-month blanking period
Primary result
As reported in the abstract
Arrhythmia recurrence
Each group vs PerAFHazard ratio (95% CI)
LsAF 1-2.4 years
1.01(0.67–1.52)
LsAF >2.4 years
2.22(1.42–3.47)
- Optimal cutoff duration of AF persistence in LsAF
- 2.4 years
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Arrhythmia recurrence, PVI-plusvs PVI-alone, in LsAF >2.4 years (subgroup) | 0.36 (0.14–0.89) | |
| 0.10.31310Hazard ratio (log scale) |
- Arrhythmia recurrence, PVI-plus vs PVI-alone, in LsAF >2.4 years (subgroup): interaction P = .116 (LsAF 1-2.4 years vs LsAF >2.4 years)
Original publication
Duration of atrial fibrillation persistence: Implications for recurrence risk after catheter ablation and efficacy of additional substrate ablation. Heart Rhythm. Published 1 February 2024. doi:10.
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