Predictors of late recurrence after second catheter ablation for persistent atrial fibrillation

IF 5.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Heart rhythm Pub Date : 2025-09-01 DOI:10.1016/j.hrthm.2024.10.053

Kohei Ukita MD, Yasuyuki Egami MD, Hiroaki Nohara MD, Shodai Kawanami MD, Akito Kawamura MD, Koji Yasumoto MD, Naotaka Okamoto MD, Yasuharu Matsunaga-Lee MD, Masamichi Yano MD, PhD, Masami Nishino MD, PhD, FACC, FESC

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Abstract

Background

Little has been reported on the predictors of late recurrence (LR) after second radiofrequency catheter ablation (RFCA) for persistent atrial fibrillation (AF).

Objective

This study aimed to identify the predictors of LR after second RFCA in patients with persistent AF.

Methods

We retrospectively analyzed 123 patients who underwent a second RFCA because of LR after the initial RFCA for persistent AF. LR was defined as a recurrence of atrial tachyarrhythmia >3 months after the ablation procedure. The initial RFCA included pulmonary vein isolation alone or pulmonary vein isolation plus cavotricuspid isthmus block. The predictors of LR were evaluated by the Cox proportional hazards model.

Results

In the univariate analysis, elevated brain natriuretic peptide levels, absence of pulmonary vein reconnections at the beginning of the second RFCA, and presence of early recurrence (ER, defined as a recurrence of atrial tachyarrhythmia within 3 months) after the second RFCA were associated with LR (P = .025, P = .018, and P < .001, respectively). The multivariate analysis revealed that absence of pulmonary vein reconnections and presence of ER were independent predictors of LR after the second RFCA (P = .004 and P < .001, respectively).

Conclusion

Absence of pulmonary vein reconnections and presence of ER were strongly associated with LR after the second RFCA in patients with persistent AF.

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持续性心房颤动第二次导管消融术后晚期复发的预测因素

背景：有关持续性心房颤动（房颤）第二次射频导管消融术（RFCA）后晚期复发（LR）预测因素的报道很少：关于持续性心房颤动（房颤）患者第二次射频导管消融术（RFCA）后晚期复发（LR）的预测因素鲜有报道：本研究旨在确定持续性房颤患者第二次射频导管消融术后晚期复发的预测因素：我们回顾性分析了 123 例因 LR 而接受第二次 RFCA 的持续性房颤患者。LR定义为消融术后3个月以上房性快速性心律失常复发。初次房颤消融术包括单纯肺静脉隔离术（PVI）或 PVI 加腔静脉峡阻滞术。采用 Cox 比例危险模型对 LR 的预测因素进行了评估：在单变量分析中，脑钠肽水平升高、第二次 RFCA 开始时没有肺静脉再连接、第二次 RFCA 后出现早期复发（ER，定义为 3 个月内房性快速性心律失常复发）与 LR 相关（分别为 P = 0.025、P = 0.018 和 P <0.001）。多变量分析显示，无肺静脉再连接和存在 ER 是第二次 RFCA 后 LR 的独立预测因素（分别为 P = 0.004 和 P <0.001）：结论：在持续性房颤患者中，无肺静脉再连接和存在ER与第二次RFCA后的LR密切相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart rhythm 医学-心血管系统

CiteScore

10.50

自引率

5.50%

发文量

1465

审稿时长

24 days

期刊介绍： HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.