Clinical and electrophysiological characteristics predicting the re-ablation outcome for atrial fibrillation patients
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Clinical and electrophysiological characteristics predicting the re-ablation outcome for atrial fibrillation patients Changqing Miao 1,2 & Weizhu Ju 1 & Hongwu Chen 1 & Gang Yang 1 & Fengxiang Zhang 1 & Kai Gu 1 & Mingfang Li 1 & Zidun Wang 1 & Hailei Liu 1 & Minglong Chen 1 Received: 3 June 2019 / Accepted: 10 September 2019 # Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Background Re-ablation has an important role in the control of recurrent atrial fibrillation (AF) post the first ablation. The present study was to report the outcome of AF re-ablation for patients who recurred after initial ablation, and to characterize the clinical and electrophysiological features predicting recurrence after redo ablation. Methods From January 2012 to May 2017, patients undergoing re-ablation for AF in our hospital were consecutively enrolled. Clinical and electrophysiological data for the initial and second procedure were collected retrospectively and prospectively, respectively. All patients were followed up for one year and recurrences during the time were reported. Results Totally 259 patients entered into the analysis (age, 58.4 ± 10.5 years; 169 men). At the end of one-year follow-up, 85 patients recurred with atrial arrhythmias (32.8%). In the multivariate analysis, higher CHA2DS2-VASC score (p = 0.023, 95% CI 1.03–1.53) and shorter time to recurrence after the initial ablation (p = 0.001, 95% CI 0.93–0.98) were clinical factors predictive of one-year recurrence after the repeat ablation. The reconnection of the right pulmonary vein (PV) (p = 0.034, 95% CI 0.31– 0.96) and the absence of not eliminated non-PV trigger at the second procedure (p = 0.032, 95% CI 1.25–142.80) independently predicted the better re-ablation outcome. Conclusions About one-third of patients recurred after one year following re-ablation. CHA2DS2-VASC score and time to recurrence after the initial ablation were independent clinical factors predicting recurrence. Also, electrophysiological findings during the repeat ablation (the right PV reconnection and absence of not eliminated non-PV trigger) were associated with better outcome during one year of follow-up. Keywords Atrial fibrillation . Catheter ablation . Recurrence . CHA2DS2-VASC score . Non-PV trigger . Pulmonary vein reconnection
1 Introduction Although catheter ablation has been an established therapeutic strategy for atrial fibrillation (AF) for more than one decade, recurrence of atrial arrhythmias after ablation is common [1–5]. For the recurred patients, re-ablation has been proven
to be superior to drug therapy alone [6]. To date, there is a paucity of data which illustrate the relationship between clinical and electrophysiological characteristics and re-ablation outcome. In this study, we sort to report the outcome for those patients who underwent repeat ablation and characterize the clinical and electrophysiological factors which were associated to recurrence during one-year follow-up.
Dr. Miao and Dr. Ju contributed equally to this work. * Minglon
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