What question did this study set out to answer?

To assess the rate and predictors of atrial fibrillation/flutter recurrence following catheter ablation.

January 24, 2026Journal of Cardiovascular Electrophysiology0 citations

Recurrence of Atrial Fibrillation/Flutter Over Long‐Term Follow‐Up After Index Atrial Fibrillation Catheter Ablation

JCJacob CushingUniversity of Kansas AGAmulya GuptaUniversity of Kansas Medical Center LPLauren St. PeterUniversity of Kansas

Key Result

Over an average follow-up of 6.1 years, 53.2% of patients experienced AF/AFL recurrence after catheter ablation, with several independent predictors identified.

Key Points

To assess the rate and predictors of atrial fibrillation/flutter recurrence following catheter ablation.
Analyzed data from patients undergoing first-time AF catheter ablations between 2008 and 2022.
Utilized a multivariable proportional-hazards model to identify predictors of late recurrence.
Developed a predictive model on 70% of the data and validated it on the remaining 30%.
53.2% of ablation patients experienced AF/flutter recurrence over an average follow-up of 6.1 years.
Key predictors of recurrence included early recurrence during the blanking period and female sex.
Increased left atrial size and severe fibrosis were also significant predictors of recurrence.

Structured PICO

Population

2905 consecutive patients undergoing first-time atrial fibrillation catheter ablation (age 62.9 ± 10.5 years; female 30.5%; persistent 43.6%, long-standing persistent 6.9%).

Intervention

First-time atrial fibrillation catheter ablation (primarily radiofrequency, 18.0% cryoballoon).

Outcome

Any clinically documented atrial fibrillation/flutter (AF/AFL) recurrence after a 3-month blanking period.hard clinical

Over half of patients undergoing first-time AF ablation experience recurrence over long-term follow-up (average 6.1 years), with early recurrence, female sex, and left atrial structural changes being key predictors.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

ABSTRACT Background Data on atrial fibrillation (AF)/flutter (AFL) recurrence over long‐term follow‐up after catheter ablation of AF are limited. Objective Assess the rate, predictors, and temporal trends of long‐term post‐ablation AF/AFL recurrence. Methods We analyzed consecutive first‐time AF catheter ablations between 2008 and 2022 at our center who were captured in our AF ablation registry and outcomes data were supplemented with chart review. Multivariable predictors of any clinically documented AF/AFL after 3‐month blanking period were identified with a stepwise‐selection multivariable proportional‐hazards model in randomly selected 70% data set and validated in remaining 30%. Results Among 2905 patients who underwent AF ablation (age 62.9 ± 10.5 years; female 30.5%; persistent 43.6%, long‐standing persistent 6.9%; primarily radiofrequency, cryoballoon 18.0%), within 2 years 38.0% had recurrence, and over average 6.1 ± 4.4‐years follow‐up 53.2% recurred. Multivariable predictors of recurrence (all p 3 months) AF/flutter recurrences in remaining 30%. Predictors included recurrence during blanking period (HR 2.42, 95% CI 2.13–2.74), female sex (1.39, 1.22–1.59), each cm increase in LA size (1.34, 1.21–1.49), maximum regional LA fibrosis moderate (1.46, 1.25–1.71) or severe (1.42, 1.14–1.78), every year of AF duration (1.02, 1.00–1.03), and persistent (1.19, 1.03–1.37) or long‐standing persistent AF (1.40, 1.10–1.78).

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