Key result
Successful ECV linked to ~34% lower 1-year AF recurrence after catheter ablation.
Why the study?
AF recurrence is common in the 3-month blanking period after catheter ablation, but evidence on whether electrical cardioversion affects clinical outcomes in these patients is inconsistent.
Does successful electrical cardioversion reduce 1-year AF recurrence and rehospitalization in patients with early recurrence after catheter ablation for atrial fibrillation?
Cohort (n=2,397)
Yes
Does successful electrical cardioversion reduce 1-year AF recurrence and rehospitalization in patients with early recurrence after catheter ablation for atrial fibrillation?
Odds Ratio: 0.66 (95% CI 0.49–0.88)
Absolute Event Rate: 55.9% vs 65.9%
p-value: p=0.005
Successful electrical cardioversion for early AF recurrence within 3 months post-ablation is associated with a significantly lower rate of 1-year AF recurrence, though it does not significantly impact rehospitalization rates.
May support electrical cardioversion for early post-ablation AF recurrence; hypothesis-generating and requires RCTs before practice change.
BACKGROUND: Atrial fibrillation (AF) recurrence is common in the 3-month blanking-period after catheter ablation, during which electrical cardioversion (ECV) is usually performed to restore sinus rhythm. Whether ECV can affect the clinical outcome of post-ablation AF patients is inconsistent, however. We aimed to explore the 1-year effect of ECV on AF recurrence and rehospitalization in patients experienced recurrence within 3-month after AF catheter ablation. METHODS: Patients who experienced recurrence within 3-month after AF catheter ablation procedure were enrolled from the China Atrial Fibrillation Registry (China-AF). A 1:3 Propensity score matching (PSM) method was applying to adjust the confounders between patients who had been treated by ECV or not. Logistic regression models were conducted to evaluate the association of ECV with 1-year AF recurrence and rehospitalization. RESULTS: In this study, 2961 patients experienced AF recurrence within 3-month after the procedure, and 282 of them underwent successful ECV, 2155 patients did not undergo ECV. One-year AF recurrence rates were 56.4% in ECV group versus 65.4% in non-ECV group (p = .003), and were 55.9% versus 65.9%, respectively, after PSM (adjusted odds ratio [OR] 0.66; 95% confidence interval (CI): 0.49-0.88, p = .005). However, the difference of 1-year rehospitalization rates between two groups were not statistically significant before (ECV group: 23.7% vs. non-ECV group: 22.3%, p = .595) and after PSM (ECV group: 24.4% vs. non-ECV group: 21.6%, adjusted OR1.14; 95% CI 0.81-1.62, p = .451). CONCLUSIONS: Successful ECV was associated with lower rate of one-year recurrence in patients with early recurrent AF after catheter ablation.
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Dong et al. (2021) conducted a cohort in Early recurrence of atrial fibrillation after catheter ablation (n=2,397). Electrical cardioversion vs. No electrical cardioversion was evaluated on 1-year atrial fibrillation recurrence (OR 0.66, 95% CI 0.49-0.88, p=0.005). Successful electrical cardioversion was associated with a lower rate of 1-year atrial fibrillation recurrence compared to no electrical cardioversion (55.9% vs 65.9%, adjusted OR 0.66) in patients with early recurrence after catheter ablation.
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