The association between late-phase early recurrence within the blanking period after atrial fibrillation catheter ablation and long-term recurrence: Insights from a large-scale multicenter study

• Published in: International journal of cardiology Vol. 341; pp. 39 - 45
• Main Authors: Onishi, Naoaki, Kaitani, Kazuaki, Nakagawa, Yoshihisa, Inoue, Koichi, Kobori, Atsushi, Nakazawa, Yuko, Ozawa, Tomoya, Kurotobi, Toshiya, Morishima, Itsuro, Miura, Fumiharu, Watanabe, Tetsuya, Masuda, Masaharu, Naito, Masaki, Fujimoto, Hajime, Nishida, Taku, Furukawa, Yoshio, Shirayama, Takeshi, Tanaka, Mariko, Okajima, Katsunori, Yao, Takenori, Egami, Yasuyuki, Satomi, Kazuhiro, Noda, Takashi, Miyamoto, Koji, Haruna, Tetsuya, Higashi, Yukei, Ito, Makoto, Horie, Minoru, Kusano, Kengo F., Shimizu, Wataru, Kamakura, Shiro, Shimizu, Yukiko, Hanazawa, Koji, Tamura, Toshihiro, Izumi, Chisato, Morimoto, Takeshi, Kimura, Takeshi, Shizuta, Satoshi
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 15.10.2021
• Subjects: Atrial fibrillation; Blanking period; Early recurrence; Late recurrence; Radiofrequency catheter ablation; Radiofrequency catheter ablation; Early recurrence; Late recurrence; Blanking period; Atrial fibrillation
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2021.07.053

The relationship between the timing of the first early recurrence and late recurrence after a single catheter ablation procedure for atrial fibrillation is controversial. The Efficacy of Short-Term Use of Antiarrhythmic Drugs After Catheter Ablation for Atrial Fibrillation trial followed 2038 patients who underwent radiofrequency catheter ablation for atrial fibrillation. Of the patients, 907 (45%) had early recurrences within 90 days after the initial ablation. We divided these patients into two groups according to the timing of the first early recurrence episode, namely the ER1 group (early recurrence during the early phase; 0–30 days, n = 814) and ER2 group (early recurrence during the late phase; 31–90 days, n = 93). Three years after ablation, patients with early recurrences had a significantly lower event-free rate from late recurrences after a 90-day blanking period than patients without early recurrences (36.2% and 74.2%, respectively; log-rank, P < 0.0001). Three years after ablation, the event-free rate was significantly higher in the ER1 than the ER2 group (38.3% and 17.1%, respectively; log-rank, P < 0.0001). Moreover, the event-free rate at 3 years in the ER2 group was extremely low (5.6%) in patient with non-paroxysmal atrial fibrillation. Early recurrences were strongly associated with late recurrences, especially in patients with the first recurrence episode at >1 month within the blanking period after a single ablation procedure. Therefore, these patients should undergo close observation during follow-up, when they had especially with non-paroxysmal atrial fibrillation. •Early recurrences after radiofrequency catheter ablation for atrial fibrillation were associated with late recurrences.•The association was observed especially in patients with the first recurrence at >1 month within the 3-month blanking period.•This was especially true in patients with non-paroxysmal atrial fibrillation.•Therefore, they should undergo close observation in the follow-up.