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, Shih Ann Chen

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Very Early Recurrence of AF. Introduction: Early 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 Results: Ablation 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. Conclusion: Very 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.

Original languageEnglish
Pages (from-to)1193-1198
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Volume22
Issue number11
DOIs
Publication statusPublished - Nov 2011

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Catheter Ablation
Atrial Fibrillation
Recurrence
Electric Countershock
Atrial Remodeling
Stroke Volume

Keywords

  • atrial fibrillation
  • cardioversion
  • catheter ablation
  • electroanatomic mapping
  • pulmonary vein isolation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Characteristics and significance of very early recurrence of atrial fibrillation after catheter ablation. / Chang, Shih Lin; Tsao, Hsuan Ming; Lin, Yenn Jiang; Lo, Li Wei; Hu, Yu Feng; Tuan, Ta Chuan; Suenari, Kazuyoshi; Tai, Ching Tai; Li, Cheng Hung; Chao, Tze Fan; Lin, Yung Kuo; Tsai, Chin Feng; Wu, Tsu Juey; Chen, Shih Ann.

In: Journal of Cardiovascular Electrophysiology, Vol. 22, No. 11, 11.2011, p. 1193-1198.

Research output: Contribution to journalArticle

Chang, SL, Tsao, HM, Lin, YJ, Lo, LW, Hu, YF, Tuan, TC, Suenari, K, Tai, CT, Li, CH, Chao, TF, Lin, YK, Tsai, CF, Wu, TJ & Chen, SA 2011, 'Characteristics and significance of very early recurrence of atrial fibrillation after catheter ablation', Journal of Cardiovascular Electrophysiology, vol. 22, no. 11, pp. 1193-1198. https://doi.org/10.1111/j.1540-8167.2011.02095.x
Chang, Shih Lin ; Tsao, Hsuan Ming ; Lin, Yenn Jiang ; Lo, Li Wei ; Hu, Yu Feng ; Tuan, Ta Chuan ; Suenari, Kazuyoshi ; Tai, Ching Tai ; Li, Cheng Hung ; Chao, Tze Fan ; Lin, Yung Kuo ; Tsai, Chin Feng ; Wu, Tsu Juey ; Chen, Shih Ann. / Characteristics and significance of very early recurrence of atrial fibrillation after catheter ablation. In: Journal of Cardiovascular Electrophysiology. 2011 ; Vol. 22, No. 11. pp. 1193-1198.
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abstract = "Very Early Recurrence of AF. Introduction: Early 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 Results: Ablation 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. Conclusion: Very 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.",
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T1 - Characteristics and significance of very early recurrence of atrial fibrillation after catheter ablation

AU - Chang, Shih Lin

AU - Tsao, Hsuan Ming

AU - Lin, Yenn Jiang

AU - Lo, Li Wei

AU - Hu, Yu Feng

AU - Tuan, Ta Chuan

AU - Suenari, Kazuyoshi

AU - Tai, Ching Tai

AU - Li, Cheng Hung

AU - Chao, Tze Fan

AU - Lin, Yung Kuo

AU - Tsai, Chin Feng

AU - Wu, Tsu Juey

AU - Chen, Shih Ann

PY - 2011/11

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N2 - Very Early Recurrence of AF. Introduction: Early 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 Results: Ablation 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. Conclusion: Very 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.

AB - Very Early Recurrence of AF. Introduction: Early 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 Results: Ablation 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. Conclusion: Very 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.

KW - atrial fibrillation

KW - cardioversion

KW - catheter ablation

KW - electroanatomic mapping

KW - pulmonary vein isolation

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