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Acute and long-term outcome of redo catheter ablation for recurrent atrial tachycardia and recurrent atrial fibrillation in patients with prior atrial fibrillation ablation

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Abstract

Purpose

Organized atrial tachycardia (AT) accounts for a substantial proportion of recurrence after radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). We sought to analyze the characteristics and long-term outcome of redo RFCA for recurrent AT compared with those for recurrent AF.

Methods

We analyzed 133 patients who underwent prior AF ablation and presented for redo RFCA procedure. Documented rhythm at recurrence was AT in 50 patients (37.6%) and AF in 83 patients (62.4%). Redo ablation was conducted using a stepwise approach in all subjects.

Results

Recurrent arrhythmia was more frequently a persistent type in the AT group (70.0% vs. 36.1% in the AT and AF group, respectively, p < 0.001). Fifty mappable ATs were identified in the AT group. Perimitral reentry was most common (19/50), followed by PV-related focal or reentrant tachycardia (16/50). During the redo RFCA, PV reconnection rate and linear ablation rate were similar in the two groups, while the focal target ablation tended to be conducted more frequently in the AF group (26.0% vs. 42.2%, p = 0.060). The AT group showed a higher acute success rate (92.0% vs. 75.9%, p = 0.019) and higher arrhythmia freedom during a mean of 30 months (76.0% vs. 55.4%, p = 0.030), compared with the AF group. The AT group and de novo AF type (paroxysmal) were independent predictors for higher arrhythmia freedom.

Conclusions

RFCA for recurrent AT following AF ablation showed favorable acute and long-term success rates and was associated with superior procedural outcomes compared with those for recurrent AF.

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Data availability

Data are not available for the public, but can be provided by relevant requests from investigators.

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Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea

    Young Choi, Sunhwa Kim, Ju Yeol Baek, Sung-Hwan Kim & Yong-Seog Oh

  2. Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, South Korea

    Ju Youn Kim

  3. Division of Cardiology, Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, South Korea

    Tae-Seok Kim

  4. Division of Cardiology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, South Korea

    Youmi Hwang & Ji-Hoon Kim

  5. Division of Cardiology, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea

    Sung-Won Jang

  6. Division of Cardiology, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea

    Man Young Lee

Authors
  1. Young Choi
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  2. Sunhwa Kim
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  3. Ju Yeol Baek
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  4. Sung-Hwan Kim
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  7. Youmi Hwang
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  8. Ji-Hoon Kim
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  11. Yong-Seog Oh
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Contributions

CY drafted the manuscript. CY, KSH, and OYS enrolled the subjects and collected data. KS, PJY, KS, and KJY contributed to data interpretation and analysis. KTS, HYM, KJH, JSW, and LMY contributed to the article revision and data researching. OYS substantially contributed to the study conceptualization and the completion of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yong-Seog Oh.

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The authors declare that they have no conflict of interest.

Ethics approval

The study was approved by the Institutional Review Board of our medical center.

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The written informed consent from the subjects was waived by the Institutional Review Board.

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Choi, Y., Kim, S., Baek, J.Y. et al. Acute and long-term outcome of redo catheter ablation for recurrent atrial tachycardia and recurrent atrial fibrillation in patients with prior atrial fibrillation ablation. J Interv Card Electrophysiol 61, 227–234 (2021). https://doi.org/10.1007/s10840-020-00795-x

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  • DOI: https://doi.org/10.1007/s10840-020-00795-x

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