Key result
Baseline RBBB or IVCD shows no association with recurrent AF after catheter ablation.
Why the study?
The association between bundle branch block and recurrence of atrial fibrillation after catheter ablation is unclear.
Does the presence of right bundle branch block or intraventricular conduction delay predict recurrence of atrial fibrillation in patients undergoing catheter ablation?
Cohort (n=477)
No
Does the presence of right bundle branch block or intraventricular conduction delay predict recurrence of atrial fibrillation in patients undergoing catheter ablation?
In middle-aged patients with low cardiovascular risk profiles, having a baseline RBBB or IVCD does not significantly increase the likelihood of AF recurrence after catheter ablation.
Baseline RBBB or IVCD does not predict post-ablation AF recurrence in this cohort; leaves open its role in higher-risk or prospective populations.
BACKGROUND: The association between bundle branch block (BBB) and recurrence of atrial fibrillation (AF) after catheter ablation is unclear. The aim of this study was to determine whether AF combined with BBB is associated with AF recurrence after catheter ablation. METHODS: A total of 477 consecutive AF patients who underwent catheter ablation were included. The AF patients were divided into three groups according to BBB: AF without BBB (n = 427), AF with right bundle branch block (AF with RBBB) (n = 16), and AF with intraventricular conduction delay (AF with IVCD) (n = 34). During a mean follow-up of 15.2 ± 6.7 months, 119 patients (24.9%) had recurrence of AF. Of these, 111 (26%) patients were in the AF without BBB group, with 2 (12.5%) and 6 (17.6%) patients in the RBBB and IVCD groups, respectively. The Kaplan-Meier estimate of the rate of recurrent AF was not significantly different among the three groups (p = .39). Multivariable analysis showed that persistent AF (HR 1.7, 95% CI 1.15-2.50, p = .007), chronic kidney disease (HR 2.94, 95% CI 1.20-7.17, p = .01), and left atrial diameter (HR 1.04, 95% CI 1.009-1.082, p = .01) were significantly associated with AF recurrence. CONCLUSION: AF with BBB was not significantly associated with the recurrence of AF after catheter ablation in middle-aged patients with low-risk cardiovascular profile.
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Lee et al. (2023) conducted a cohort in Atrial fibrillation (n=477). Right bundle branch block (RBBB) or intraventricular conduction delay (IVCD) vs. Atrial fibrillation without bundle branch block was evaluated on Recurrence of atrial tachyarrhythmia (AF, atrial flutter, or atrial tachycardia >30 s) after a 3-month blanking period (No significant difference among groups, p=0.39). The presence of right bundle branch block or intraventricular conduction delay was not significantly associated with recurrent atrial fibrillation after catheter ablation.
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