Key result
Radiofrequency catheter ablation with contact force technology had a 35.2% late recurrence rate vs 55.7% without CF, and early recurrence in the 3rd month universally predicted late recurrence.
Why the study?
The 3-month blanking period definition for early recurrence of AF is based on data without contact force technology, leaving its significance as a risk factor for late recurrence unclear in the contact force era.
Does radiofrequency catheter ablation with contact force technology reduce late recurrence of atrial fibrillation compared to non-contact force ablation in patients with paroxysmal atrial fibrillation?
Cohort (n=395)
Does radiofrequency catheter ablation with contact force technology reduce late recurrence of atrial fibrillation compared to non-contact force ablation in patients with paroxysmal atrial fibrillation?
Early recurrence in the 3rd month after contact force-guided ablation for paroxysmal AF strongly predicts late recurrence, suggesting the standard 3-month blanking period could be shortened to 2 months in the contact force era.
May support shortening the blanking period after contact force ablation; leaves open need for randomized confirmation in paroxysmal AF.
Introduction: Early recurrence (ER) of atrial fibrillation (AF) is defined as the recurrence of atrial tachyarrhythmias within 3 months after AF ablation, however, this definition is based on data from the era of radiofrequency catheter ablation (RFCA), without contact force (CF) technology. We investigated the significance of ER as a risk factor for late recurrence (LR) in paroxysmal AF (PAF) patients treated with CF and non-CF-guided ablation. Methods and Results: We studied 395 patients with PAF who underwent RFCA. Of these, 97 patients underwent RFCA without CF technology (Non-CF group) and 298 underwent with CF technology (CF group). Over a 2-year post-ablation follow-up period, LR occurred in 54 of 97 (55.7%) patients in the Non-CF group, and in 105 of 298 (35.2%) patients in the CF group. ER had a more significant relationship with LR in the CF than in the Non-CF group, and all patients in the CF group with ER in the 3rd month developed LR. Conclusion: ER in PAF patients who have undergone CF-guided ablation have a greater risk of LR than those who have undergone non-CF-guided ablation. ER in the 3rd month after CF-guided ablation may indicate an absolute risk of LR. Blanking period could be defined as 2 months in the CF era.
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Uetake et al. (2020) conducted a cohort in Paroxysmal atrial fibrillation (PAF) (n=395). Radiofrequency catheter ablation with contact force (CF) technology vs. Radiofrequency catheter ablation without CF technology was evaluated on Late recurrence (LR) of atrial fibrillation. Radiofrequency catheter ablation with contact force technology had a 35.2% late recurrence rate vs 55.7% without CF, and early recurrence in the 3rd month universally predicted late recurrence.
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