Arrhythmias & electrophysiology
Time course of recurrent arrhythmias in clinical trials of catheter ablation for paroxysmal atrial fibrillation: A pooled analysis
Authors' conclusion
The timing of arrhythmia recurrence after paroxysmal AF catheter ablation is nonuniform, with the relative yield of active monitoring decreasing as time increases from the index intervention. Shortening the postblanking period follow-up may allow for a less expensive clinical trial and enable earlier knowledge translation, without substantially compromising detection of recurrent arrhythmia.
Study context
- Population
- Patients undergoing catheter ablation for paroxysmal atrial fibrillation (AF) in randomized clinical trials
- Participants
- 10,246 patients42 trials
- Outcome
- Pooled arrhythmia-free survival after index ablation (inclusive of a 3-month blanking period)
- Follow-up
- 4, 6, 9 and 12 months
Methodological detailspooled analysis, inverse Kaplan-Meier reconstruction of time-to-event distribution
- Pooled analysis
- Inverse Kaplan-Meier reconstruction of time-to-event distribution
Pooled result
As reported in the abstract
4 months
90.4%
95% CI 89.8–90.9
6 months
83.4%
95% CI 82.7–84.1
9 months
77.2%
95% CI 76.4–78.0
12 months
72.8%
95% CI 71.9–73.7
Further pooled results
Share of total recurrences occurring by postablation month · months 4, 6 and 9
- By month 4
- 35.9% (CI, 34.9-36.8)
- By month 6
- 61.5% (CI, 59.9-63.0)
- By month 9
- 85.2% (CI, 83.1-87.4)
- Timing of recurrences front-loaded
Prediction of 12-month arrhythmia-free survival from reported 6-month survival
- Absolute mean error
- 4.2% (standard deviation, 2.8%)
Original publication
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