Arrhythmias & electrophysiology
Incremental Efficacy for Repeat Ablation Procedures for Catheter Ablation of Atrial Fibrillation: 5-Year Follow-Up
Authors' conclusion
Although repeated ablations demonstrated significant benefits at the individual level, the success rate may drop off after a third. The overall success of the initial cohort was not significantly influenced by the success rates of multiple follow-up ablations.
Study context
- Population
- Patients undergoing catheter ablation of atrial fibrillation (AF), 2004–2019
- Participants
- 2,194 / 576 / 103 / 20
- Exposure
- First, second, third and fourth AF ablation
- First ablationn = 2,194
- Second ablationn = 576
- Third ablationn = 103
- Fourth ablationn = 20
- Outcome
- Freedom from AF (recurrence: documented atrial arrhythmia >30 seconds)
- Follow-up
- 5-year follow-up
Methodological detailsKaplan-Meier analysis, log rank test, 24-to-48-hour Holter every 3 months in year 1, then every 6 to 12 months
- Kaplan-Meier analysis, log rank test
- 24-to-48-hour Holter every 3 months in year 1, then every 6 to 12 months
Main finding
As reported in the abstract
Freedom from AF (success rate)
- Freedom from AF after 1 ablation
- 52%
- Freedom from AF in entire cohort after second ablation (from 52%)
- 66%
- Freedom from AF in entire cohort after third ablation
- 67%
- Freedom from AF in entire cohort after fourth ablation
- 67%
Observational data: associations, not effects.
Further findings
Cumulative freedom from AF in entire cohort
- After 1 ablation
- 52%
- After second ablation
- 66%
- After third ablation
- 67%
- After fourth ablation
- 67%
Repeat ablation among patients with recurrence (n = 1,052)
- Underwent second ablation
- 576 (55%)
- Underwent third ablation
- 103 (10%)
- Underwent fourth ablation
- 20 (2%)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Incremental Efficacy for Repeat Ablation Procedures for Catheter Ablation of Atrial Fibrillation: 5-Year Follow-Up. JACC Adv. Published 19 August 2024. doi:10.
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