Arrhythmias & electrophysiology
Late recurrence of atrial fibrillation 5 years after catheter ablation: predictors and outcome
Authors' conclusion
Patients with a later CR exhibited a smaller LA volume, lower LA voltage, and higher extra-pulmonary vein triggers during the repeat procedure, suggesting AF progression.
Study context
- Population
- Patients with clinical atrial fibrillation (AF) recurrence after de novo AF catheter ablation with protocol-based rhythm follow-upof 4248 ablated
- Participants
- 1,417 patients
- Exposure
- Clinical recurrence >5 years vs earlier recurrence after AF catheter ablation
- Within 1 yrn = 645
- 1-2 yrn = 339
- 2-5 yrn = 308
- CR>5 yrn = 125
- Outcome
- Factors independently associated with CR>5 yr
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
CR>5 yrOdds ratio (CI)P value
Low LA volume
0.99(0.98–1.00)
P = 0.035Low LA voltage
0.61(0.38–0.94)
P = 0.032Lower early recurrence
0.40(0.23–0.67)
P < 0.001- Higher proportion of paroxysmal AF with CR>5 yr
- P = 0.031
- Lower left atrial (LA) volume (CT) with CR>5 yr
- P = 0.003
- Lower LA voltage with CR>5 yr
- P = 0.003
- Lower frequency of early recurrence with CR>5 yr
- P < 0.001
- Lower use of post-procedure anti-arrhythmic drugs with CR>5 yr
- P < 0.001
Observational data: associations, not effects.
Further findings
Extra-pulmonary vein triggers during repeat procedures (198 patients)
- Significantly greater with CR>5 yr, despite no difference in de novo protocol
- P for trend 0.003
Rhythm outcomes of repeat ablation
- No difference according to timing of CR
- log-rank P = 0.330
Original publication
Late recurrence of atrial fibrillation 5 years after catheter ablation: predictors and outcome. Europace. Published 26 April 2023. doi:10.
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