Effect of atrial fibrillation recurrence time after catheter ablation on the prognosis of redo ablation

Guo Xueyuan; Long Deyong; Yu Ronghui; Tang Ribo; Sang Caihua; Jiang Chenxi; Li Songnan; Du Xin; Dong Jianzeng; Ma Changsheng

doi:10.3760/j.issn.1673-4777.2018.07.001

Abstract：Objective To investigate the effect of the recurrence time of atrial fibrillation (AF) after initial catheter ablation on the prognosis of redo ablation.Methods A total of 228 patients undergoing the second time of AF catheter ablation in Beijing Anzhen Hospital,Capital Medical University from January 2009 to June 2011 were consecutively included.According to the recurrence time of AF,the patients were divided into early recurrence group (＜ 3 months,n =128),late recurrence group (3-12 months,n =59) and extremely late recurrence group(＞ 12 months,n =41).All patients were followed up 3,6,12 months after procedure and every 6 months subsequently beyond 12 months;the maintenance rate of sinus rhythm without antiarrhythmic intervention was observed.The effect of AF recurrence time on the outcome of redo procedure was analyzed.Results During (30 ± 7) months of follow-up,the maintenance rate of sinus rhythm without antiarrhythmic intervention was 61.7％ (n =79) in early recurrence group,74.6％ (n =44) in late recurrence group and 80.5％ (n =33) in extremely late recurrence group;the maintenance rate of sinus rhythm in extremely late recurrence group was significantly higher than that in other 2 groups (P =0.038).Univariate Cox analysis showed that persistent AF (hazard rate =1.600,95 ％ confidence interval:1.006-2.542,P =0.047) and extremely late recurrence (risk ratio =0.446,95％ confidence interval:0.211-0.942,P =0.034) were related to the recurrence of AF after redo ablation.Multivariate analysis revealed that extremely late recurrence was an independent predictor of maintenance of sinus rhythm after redo ablation (hazard rate =0.448,95％ confidence interval:0.212-0.946,P =0.035).Conclusions The recurrence time of AF after catheter ablation has significant influence on the prognosis of redo ablation.Patients with late AF recurrence may have high success rate of redo ablation.