Predictors of Atrial Fibrillation Recurrences after a First Radiofrequency Catheter Ablation Intervention for Paroxysmal Atrial Fibrillation—Experience of a Low Volume Ablation Centre

Abstract

Background and Objectives: Atrial fibrillation recurrences (AFR) after radiofrequency catheter ablation (RFCA) are not uncommon, up to 65% of patients having relapses in the first year. However, current data are based mainly on studies from centres with a large volume of ablations, as they include technically inhomogeneous interventions, and populations with different types of AF. The aim of our study was to assess and stratify the risk at 6 and 12 months for AFR after a single RFCA, in patients with paroxysmal AF, in a centre with low volume activity. Materials and Methods: We enrolled 40 patients who underwent an initial RFCA, followed by continuous 48 h ECG monitoring at 1, 3, 6, and 12 months. Patients self-monitored their cardiac activity by random daily radial pulse palpation or in the presence of palpitations. Results: Ten independent predictors for late AFR were identified, and a 6-month risk score was computed using three of them: AFR duration in the first month, number of AFR between 1 and 3 months, and supraventricular ectopics per 24 h at 6 months. The score can explain 59% of the AFR (p = 0.001). A further 12-month assessment identified three independent predictors. The presence of AFR between 6–12 months is the most important of them (OR = 23.11, 95% CI = 3.87–137.83, p = 0.001), explaining 45% of AFR over 1 year. The risk scores at 6 and 12 months were internally validated. Conclusions: The 6-month score proved to be a useful tool in guiding further strategy for patients with a low risk, while a longer follow-up to 12 months may avoid unnecessary early reinterventions.

Some Echocardiographic Indicators as Probable Predictors of Atrial Fibrillation Recurrence in Patients with Arterial Hypertension after Catheter Ablation

“…A number of studies have identified some predictors of AF recurrence after catheter ablation methods, but their predictive level is insufficient. In this regard, this issue remains relevant and needs further research [19], [20], [21], [22], [23], [24], [25], [26].…”

Early detection of obstructive sleep apnea in patients with atrial fibrillation

“…This apnea-hypopnea index (i.e., OSA severity) independently predicts the risk of incident and recurrent AF (Zhao et al, 2018). Positive airway pressure (PAP) is the gold standard and the most recommended treatment for OSA, may reverse or mitigate atrial dysfunction, and is associated with a 42% relative risk reduction of recurrent AF (Matei et al, 2021). Further, recent observational evidence suggests that PAP may improve the efficacy of ablative and cardioversion therapies, decrease the cumulative burden of AF, and modify cardiovascular risk (Virani et al, 2021).…”