Predictive Value of Early Recurrence and Delayed Cure After Catheter Ablation for Patients With Chronic Atrial Fibrillation

Li, Xu Ping; Dong, Jian; Liu, Xing Peng; Long, De Yong; Yu, Rong; Tian, Yin; Tang, Ruiyi; Zheng, Bin; Hu, Fu; Shi, Liang; He, Hua; Sheng, Chang

doi:10.1253/circj.72.1125

Cited by 39 publications

(8 citation statements)

References 25 publications

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“… 974 Nevertheless, early recurrences have been shown to predict arrhythmia recurrences late after catheter ablation of AF in some patients. 260 , 329 , 935 , 976 , 977 , 978 …”

Section: Section 8: Follow-up Considerationsmentioning

confidence: 99%

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation

et al. 2017

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“… 974 Nevertheless, early recurrences have been shown to predict arrhythmia recurrences late after catheter ablation of AF in some patients. 260 , 329 , 935 , 976 , 977 , 978 …”

Section: Section 8: Follow-up Considerationsmentioning

confidence: 99%

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation

et al. 2017

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“…27 These findings challenge the notion that recurrence during the 3-month blanking period is a transient and clinically insignificant result of periprocedural inflammation. 6,28 F I G U R E 1 Kaplan-Meier curves for LAVi and early recurrence. The cut-off of LAVi was obtained from survival tree analysis.…”

Section: Significance Of Early Recurrencementioning

confidence: 99%

Using machine learning to enhance prediction of atrial fibrillation recurrence after catheter ablation

Brahier,

Zou,

Abdulkareem

et al. 2023

Journal of Arrhythmia

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BackgroundTraditional risk scores for recurrent atrial fibrillation (AF) following catheter ablation utilize readily available clinical and echocardiographic variables and yet have limited discriminatory capacity. Use of data from cardiac imaging and deep learning may help improve accuracy and prediction of recurrent AF after ablation.MethodsWe evaluated patients with symptomatic, drug‐refractory AF undergoing catheter ablation. All patients underwent pre‐ablation cardiac computed tomography (cCT). LAVi was computed using a deep‐learning algorithm. In a two‐step analysis, random survival forest (RSF) was used to generate prognostic models with variables of highest importance, followed by Cox proportional hazard regression analysis of the selected variables. Events of interest included early and late recurrence.ResultsAmong 653 patients undergoing AF ablation, the most important factors associated with late recurrence by RSF analysis at 24 (+/−18) months follow‐up included LAVi and early recurrence. In total, 5 covariates were identified as independent predictors of late recurrence: LAVi (HR per mL/m2 1.01 [1.01–1.02]; p < .001), early recurrence (HR 2.42 [1.90–3.09]; p < .001), statin use (HR 1.38 [1.09–1.75]; p = .007), beta‐blocker use (HR 1.29 [1.01–1.65]; p = .043), and adjunctive cavotricuspid isthmus ablation [HR 0.74 (0.57–0.96); p = .02]. Survival analysis demonstrated that patients with both LAVi >66.7 mL/m2 and early recurrence had the highest risk of late recurrence risk compared with those with LAVi <66.7 mL/m2 and no early recurrence (HR 4.52 [3.36–6.08], p < .001).ConclusionsMachine learning‐derived, full volumetric LAVi from cCT is the most important pre‐procedural risk factor for late AF recurrence following catheter ablation. The combination of increased LAVi and early recurrence confers more than a four‐fold increased risk of late recurrence.

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“…Prior studies have identified clinical and demographic characteristics, arrhythmia characteristics, electrocardiographic and echocardiographic characteristics, and AF ablation procedural and post-procedural characteristics which are predict the development of ERAA after ablation, several of which we have listed in Table 1[2,5,7,10-22]. …”

Section: Predictors Of Eraamentioning

confidence: 99%

Mechanisms and clinical significance of early recurrences of atrial arrhythmias after catheter ablation for atrial fibrillation

Liang

Santangeli

2016

WJC

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Early recurrence of atrial arrhythmias (ERAA) after ablation is common and strongly predicts late recurrences and ablation failure. However, since arrhythmia may eventually resolve in up to half of patients with ERAA, guidelines do not recommend immediate reintervention for ERAA episodes occurring during a 3-mo post-ablation blanking period. Certain clinical demographic, electrophysiologic, procedural, and ERAA-related characteristics may predict a higher likelihood of long-term ablation failure. In this review, we aim to discuss potential mechanisms of ERAA, and to summarize the clinical significance, prognostic implications, and treatment options for ERAA.

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Predictive Value of Early Recurrence and Delayed Cure After Catheter Ablation for Patients With Chronic Atrial Fibrillation

Cited by 39 publications

References 25 publications

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation

Using machine learning to enhance prediction of atrial fibrillation recurrence after catheter ablation

Mechanisms and clinical significance of early recurrences of atrial arrhythmias after catheter ablation for atrial fibrillation

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