Recurrence of paroxysmal AF after ablation of chronic AF was associated with reverse remodeling and higher sinus rhythm maintenance (100% vs 70%, P=0.02) compared to persistent AF recurrence.
Cohort (n=120)
What are the electrical and structural remodeling patterns associated with different types of AF recurrence after catheter ablation of chronic AF?
Absolute Event Rate: 100% vs 70%
p-value: p=0.02
BACKGROUND: Multiple remodeling patterns have been observed after catheter ablation of atrial fibrillation (AF). OBJECTIVE: We aimed to clarify the electrical/structural properties associated with recurrences after ablation of chronic AF. METHODS: After a stepwise ablation procedure in 120 consecutive patients with persistent/long-lasting persistent AF, 36 had a recurrence of AF (Group 1/Group 2: recurrence with paroxysmal/persistent AF, n = 16/20). RESULTS: During the first procedure, the left atrial (LA) bipolar voltage did not differ between the 2 groups, and the LA volume was smaller in Group 1 than in Group 2 and it was the only factor predicting the recurrent types (P = 0.009, OR = 1.04). In the second procedure, the bipolar voltage of the global left atrium increased (1.33 ± 0.11 mV vs 1.76 ± 0.16 mV, P = 0.001) in Group 1 and decreased (1.31 ± 0.14 mV vs 0.90 ± 0.12 mV, P = 0.01) in Group 2, when compared with that of the first procedure. The LA low-voltage area (<0.5 mV) decreased in Group 1, and increased in Group 2. The LA volume (90 ± 8 cm(3) vs 72 ± 8 cm(3), P = 0.002) decreased in the second procedure in Group 1. It remained the same in Group 2. The right atrial substrates did not change between the procedures. After a follow-up of 27 ± 3 months, all patients in Group 1 and 14 patients in Group 2 remained in sinus rhythm (P = 0.02). CONCLUSION: A better outcome with reverse electrical and structural remodeling occurred after the ablation of chronic AF when the recurrence was paroxysmal AF. Progressive electrical remodeling without any structural remodeling developed in those with a recurrence involving persistent AF.
Lo et al. (Wed,) conducted a cohort in Chronic atrial fibrillation (n=120). Recurrence with paroxysmal AF vs. Recurrence with persistent AF was evaluated on Maintenance of sinus rhythm at follow-up (p=0.02). Recurrence of paroxysmal AF after ablation of chronic AF was associated with reverse remodeling and higher sinus rhythm maintenance (100% vs 70%, P=0.02) compared to persistent AF recurrence.