Clinical impact of very early recurrence of atrial fibrillation after radiofrequency catheter ablation

Abstract

Background: Little has been reported on the impact of very early recurrence of atrial fibrillation (VERAF) after radiofrequency catheter ablation (RFCA).

Methods: We enrolled 201 consecutive patients who underwent an initial RFCA of atrial fibrillation (AF) between September 2014 and April 2019 in our hospital and experienced early recurrence of AF (ERAF, defined as recurrence of atrial tachyarrhythmia within 3 months after RFCA). These patients were categorized into three groups: Group A who experienced recurrence of atrial tachyarrhythmia only within 48 h after RFCA, Group B who experienced recurrence of atrial tachyarrhythmia both within 48 h and between 48 h and 3 months after RFCA, and Group C who experienced the first recurrence of atrial tachyarrhythmia between 48 h and 3 months after RFCA. We compared the patient characteristics, ablation procedure and procedure-related complications, and clinical outcomes among the three groups. In addition, we investigated the pulmonary vein (PV) reconnections in the patients who experienced a repeat ablation procedure due to late recurrence of AF (LRAF, defined as recurrence of atrial tachyarrhythmia between 3 and 12 months after RFCA).

Results: The Group A, B, and C consisted of 54, 40, and 107 patients, respectively. The inflammatory markers on the second day of RFCA were significantly higher in Group A. Moreover, Group A had a lower incidence of LRAF (p < 0.001) and PV reconnections at repeat ablation procedure (p = 0.023).

Conclusions: VERAF may have better clinical outcomes including lower incidence of LRAF and PV reconnections among patients with ERAF.

Keywords: Atrial fibrillation; Catheter ablation; Early recurrence; Late recurrence; Pulmonary vein reconnection.