Left atrial enlargement after the original catheter ablation was associated with a higher risk of recurrence after repeat ablation compared to no enlargement (HR 2.22; 95% CI 1.02-4.81; P=0.043).
Cohort (n=95)
Does left atrial enlargement predict recurrence after repeat catheter ablation in patients with paroxysmal atrial fibrillation?
Left atrial enlargement after an initial catheter ablation for paroxysmal AF is an independent predictor of recurrence following a repeat ablation procedure.
Effect estimate: HR 2.22 (95% CI 1.02-4.81)
Absolute Event Rate: 51.4% vs 25%
p-value: p=0.043
AIMS: This study sought to explore the predictors of recurrence in patients with paroxysmal atrial fibrillation (AF) undergoing repeat catheter ablation, especially the impact of left atrial (LA) remodelling after the original procedure on the outcome of repeat procedure. METHODS AND RESULTS: Ninety-five patients undergoing repeat ablation were enrolled in this study. Repeat procedure endpoints were pulmonary vein isolation, linear block when linear ablation is performed, and non-inducibility of atrial tachyarrhythmia by burst pacing. Patients with LA enlargement between the pre-original procedure and pre-repeat procedure were categorized as Group 1 (35 patients), while individuals with no change or decrease of LA diameter were categorized as Group 2 (60 patients). The mean duration from the original procedure to the repeat procedure was 12 months (1-40 months). After 29.6 ± 20.5 (3-73) months follow-up from the repeat procedure, 33 patients experienced recurrence (34.7%). The recurrence rate was significantly higher in Group 1 than in Group 2 (51.4 VS. 25.0%, P = 0.017). In univariate analysis, LA remodelling was the only predictor of recurrence. In multivariate analysis, after adjustment for age and LA diameter, Group 1 had a greater risk of recurrence after the repeat procedure (hazard ratio = 2.22, 95% confidence interval: 1.02-4.81, P = 0.043). CONCLUSIONS: Left atrial enlargement after undergoing the original catheter ablation of paroxysmal AF was an independent risk factor of recurrence after repeat ablation.
Tang et al. (Tue,) conducted a cohort in Paroxysmal atrial fibrillation (n=95). Left atrial enlargement between original and repeat procedure vs. No change or decrease in left atrial diameter was evaluated on Recurrence of atrial fibrillation (HR 2.22, 95% CI 1.02-4.81, p=0.043). Left atrial enlargement after the original catheter ablation was associated with a higher risk of recurrence after repeat ablation compared to no enlargement (HR 2.22; 95% CI 1.02-4.81; P=0.043).