Atrial Tachycardias Following Persistent Atrial Fibrillation Ablation: Predictors of Recurrence After the Repeat Ablation

Sonia Ammar‐Busch; Bernhard M. Kaess; A. Bruhm; Tilko Reents; Félix Bourier; Alessandra Buiatti; Verena Semmler; Marta Telishevska; Marc Kottmaier; Gabriele Hessling; Isabel Deisenhofer

doi:10.1111/jce.12817

August 20, 2015Journal of Cardiovascular Electrophysiology

Atrial Tachycardias Following Persistent Atrial Fibrillation Ablation: Predictors of Recurrence After the Repeat Ablation

View Full Paper

Ask AI

Bookmark

Share

Why the study?

What are the predictors of atrial tachycardia recurrence after repeat ablation for secondary AT following persistent AF ablation?

Structured PICO

What are the predictors of atrial tachycardia recurrence after repeat ablation for secondary AT following persistent AF ablation?

P

Population

117 patients who underwent ablation for secondary atrial tachycardias (AT) arising after a previous ablation for persistent atrial fibrillation (AF)

I

Intervention

Repeat ablation for secondary atrial tachycardias

O

Outcome

Atrial tachycardia (AT) recurrencehard clinical

In patients undergoing repeat ablation for secondary atrial tachycardias after persistent AF ablation, the presence of multiple AT forms during the procedure is a significant predictor of recurrence.

Implication

Identifies predictors of post-repeat AT recurrence; leaves open whether targeted interventions improve outcomes in this cohort.

Abstract

BACKGROUND: Repeat procedures after persistent atrial fibrillation (AF) ablation are frequently performed for secondary atrial tachycardias (AT). Predictors of AT recurrence after the first repeat ablation have not yet been studied. METHODS: We investigated predictors of AT recurrence in 117 patients who underwent ablation for secondary AT arising after a previous ablation for persistent AF using the Cox proportional hazards model. RESULTS: Acute ablation success rate was 94%. Over a follow-up period of 12 months, 61 patients (53%) were free from AT recurrence. Of the assessed predictors of AT recurrence, the number of ablated AT forms (>1 vs. 1) was significantly associated with AT recurrence (hazard ratio 2.01, 95% CI 1.18-3.43, P = 0.01). Other variables including left atrial diameter, AT mechanism, or the characteristics of previous AF ablation did not have significant influence on AT recurrence (P>0.05). Men had a tendency toward fewer AT recurrences than women (OR 0.60, 95% CI 0.34-1.05, P = 0.07). During a second AT ablation procedure, 19 (49%) patients were identified to have a recurrence of the previously ablated AT, whereas in 20 patients (51%) a new AT form was diagnosed. CONCLUSION: Ablation of atrial tachycardias following persistent AF ablation has a high acute success rate. However, a substantial number of patients develop new onset AT during follow-up. The occurrence of multiple AT forms during the repeat ablation procedure was the only predictive factor for AT recurrence.