• J. Cardiovasc. Electrophysiol. · Nov 2011

    Characteristics and significance of very early recurrence of atrial fibrillation after catheter ablation.

    • Shih-Lin Chang, Hsuan-Ming Tsao, Yenn-Jiang Lin, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Kazuyoshi Suenari, Ching-Tai Tai, Cheng-Hung Li, Tze-Fan Chao, Yung-Kuo Lin, Chin-Feng Tsai, Tsu-Juey Wu, and Shih-Ann Chen.
    • Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
    • J. Cardiovasc. Electrophysiol. 2011 Nov 1; 22 (11): 1193-8.

    IntroductionEarly restoration of sinus rhythm following ablation of atrial fibrillation (AF) facilitates reverse atrial remodeling and improves the long-term outcome. The purpose of this study was to determine the predictors and outcome in patients with very early AF recurrences (< 2 days).Methods And ResultsAblation was performed in 339 consecutive AF patients (paroxysmal AF = 262). Biatrial voltage was mapped during sinus rhythm. If recurrent AF occurred within 2 days following the ablation, electrical cardioversion was performed to restore sinus rhythm. Very early recurrences of AF occurred in 39 (15%) patients with paroxysmal AF and 26 (34%) with nonparoxysmal AF. Patients with very early recurrence had a higher incidence of nonparoxysmal AF (40% vs 18.6%, P< 0.001), requirement of electrical cardioversion during procedure, larger left atrial (LA) diameter (43 ± 7 vs 39 ± 6 mm, P< 0.001), lower left ventricular ejection fraction (54 ± 10% vs 59 ± 7, P< 0.001), longer procedural time, and lower LA voltage (1.5 ± 0.7 vs 1.9 ± 0.8 mV, P< 0.001). A multivariate analysis revealed that the independent predictors of a very early recurrence were a longer procedural time and lower LA voltage. During a follow-up of 13 ± 5 months, a very early recurrence did not predict the long-term outcome of a single procedure recurrence in the patients with paroxysmal AF, but was associated with a late recurrence in the nonparoxysmal AF patients.ConclusionVery early recurrence occurred in patients with paroxysmal AF is not associated with long-term recurrence. Nonparoxysmal AF is an independent predictor of late recurrence of AF in patients with very early recurrence.© 2011 Wiley Periodicals, Inc.

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