Very late recurrence of paroxysmal AF (>1 year post-ablation) was associated with a significantly higher incidence of right atrial foci compared to late recurrence (67% vs 3%, P<0.001).
Observational (n=50)
Do the anatomical origins of atrial fibrillation foci differ between late and very late recurrences of paroxysmal atrial fibrillation after initial catheter ablation?
Right atrial foci play a major role in very late recurrences (>1 year) of paroxysmal AF after ablation, whereas left atrial and pulmonary vein foci dominate late recurrences (<1 year).
Absolute Event Rate: 67% vs 3%
p-value: p=<0.001
INTRODUCTION: The mechanisms of late (1 year after the ablation) recurrences of paroxysmal atrial fibrillation (AF) after catheter ablation have not been reported. METHODS AND RESULTS: Fifty consecutive patients undergoing a repeated electrophysiologic study to investigate the recurrence of paroxysmal AF after the first ablation were included. Group 1 consisted of 12 patients with very late (26 +/- 13 months) and group 2 consisted of 38 patients with late (3 +/- 3 months) recurrence of paroxysmal AF. In the baseline study, group 1 had a lower incidence of AF foci from the pulmonary veins (PVs) (67% vs 92%, P = 0.048) and a higher incidence of AF foci from the right atrium (50% vs 13%, P = 0.014) than group 2. In the repeated study, group 1 had a higher incidence of AF foci from the right atrium (67% vs 3%, P < 0.001) and a lower incidence of AF foci from the left atrium (50% vs 97%, P < 0.001), including a lower incidence of AF foci from the PVs (50% vs 79%, P = 0.07) and from the left atrial free wall (0% vs 29%, P = 0.046) than group 2. Furthermore, most of these AF foci (64% of group 1, 65% of group 2) were from the previously targeted foci. CONCLUSION: The right atrial foci played an important role in the very late recurrence of AF, whereas the left atrial foci (the majority were PVs) were the major origin of the late recurrence of AF after the catheter ablation of paroxysmal AF.
HSIEH et al. (2005) conducted an observational in Paroxysmal atrial fibrillation (n=50). Very late recurrence (>1 year post-ablation) vs. Late recurrence (<1 year post-ablation) was evaluated on Incidence of AF foci from the right atrium during repeated electrophysiologic study (p=<0.001). Very late recurrence of paroxysmal AF (>1 year post-ablation) was associated with a significantly higher incidence of right atrial foci compared to late recurrence (67% vs 3%, P<0.001).
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