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Clinical and electrophysiological characteristics predicting the re-ablation outcome for atrial fibrillation patients

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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.

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Author notes

  1. Dr. Miao and Dr. Ju contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Guangzhou Road, Nanjing, 210029, Jiangsu Province, China

    Changqing Miao, Weizhu Ju, Hongwu Chen, Gang Yang, Fengxiang Zhang, Kai Gu, Mingfang Li, Zidun Wang, Hailei Liu & Minglong Chen

  2. Department of Cardiology, Jingjiang People’s Hospital, Jingjiang, Jiangsu Province, China

    Changqing Miao

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  1. Changqing Miao
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Correspondence to Minglong Chen.

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The study was approved by the ethics committee of the First Affiliated Hospital with Nanjing Medical University.

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All patients provided written informed consent before the procedure.

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Miao, C., Ju, W., Chen, H. et al. Clinical and electrophysiological characteristics predicting the re-ablation outcome for atrial fibrillation patients. J Interv Card Electrophysiol 59, 373–379 (2020). https://doi.org/10.1007/s10840-019-00666-0

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  • DOI: https://doi.org/10.1007/s10840-019-00666-0

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