Very late recurrence (>12 months) of atrial fibrillation after ablation occurred in 6% of patients and was associated with fewer multiple AF foci than late recurrence (23% vs 63%, P=0.02).
Observational (n=207)
Does very late recurrence of atrial fibrillation (>12 months) have a different clinical outcome compared to late recurrence (within 12 months) in patients who underwent catheter ablation for paroxysmal AF?
Very late recurrence of atrial fibrillation (>12 months) after ablation for paroxysmal AF is rare (6%) and associated with a more benign clinical course requiring fewer antiarrhythmic drugs than earlier recurrences.
Absolute Event Rate: 23% vs 63%
p-value: p=0.02
INTRODUCTION: High recurrence rate is still a major problem associated with ablation of paroxysmal atrial fibrillation (AF). Most of the recurrences occur within 6 months after ablation. The characteristics of very late recurrent AF (>12 months after ablation) have not been reported. METHODS AND RESULTS: Two hundred seven patients with drug-refractory AF underwent successful focal ablation or isolation of AF foci. After the first ablation procedure, Holter monitoring and event recorders were used to evaluate symptomatic recurrent AF. A second ablation procedure was recommended if the antiarrhythmic drugs could not control recurrent AF. During long-term follow-up (mean 30 +/- 11 months, up to 51 months), 70 patients had recurrent AF, including 13 patients (6%) with very late (>12 months) recurrent AF (group 1) and 57 patients (28%) with late (within 12 months after ablation) recurrent AF (group 2). Group 1 patients had a significantly lower incidence of multiple (> or = 2) AF foci (23% vs 63%, P = 0.02) than group 2 patients. In addition, the incidence of antiarrhythmic drugs use (38% vs 84%, P = 0.001) to maintain sinus rhythm after the first episode of recurrent AF was significantly lower in group 1 than group 2 patients, and the incidence of a second intervention procedure (8% vs 35%, P = 0.051) tended to be lower in group 1 than group 2 patients. CONCLUSION: The incidence of very late recurrent AF after ablation of paroxysmal AF is very low, and the clinical outcome of patients with very late recurrent AF is benign.
HSIEH et al. (2003) conducted an observational in Paroxysmal atrial fibrillation (n=207). Catheter ablation vs. Late recurrent AF (within 12 months) was evaluated on Incidence of multiple (≥2) AF foci (p=0.02). Very late recurrence (>12 months) of atrial fibrillation after ablation occurred in 6% of patients and was associated with fewer multiple AF foci than late recurrence (23% vs 63%, P=0.02).