Naoaki Onishi1, Kazuaki Kaitani2, Yoshihisa Nakagawa3, Koichi Inoue4, Atsushi Kobori5, Yuko Nakazawa6, Tomoya Ozawa6, Toshiya Kurotobi7, Itsuro Morishima8, Fumiharu Miura9, Tetsuya Watanabe10, Masaharu Masuda11, Masaki Naito12, Hajime Fujimoto13, Taku Nishida14, Yoshio Furukawa15, Takeshi Shirayama16, Mariko Tanaka17, Katsunori Okajima18, Takenori Yao19, Yasuyuki Egami20, Kazuhiro Satomi21, Takashi Noda22, Koji Miyamoto22, Tetsuya Haruna23, Yukei Higashi24, Makoto Ito25, Minoru Horie6, Kengo F Kusano22, Wataru Shimizu26, Shiro Kamakura27, Yukiko Shimizu28, Koji Hanazawa29, Toshihiro Tamura30, Chisato Izumi31, Takeshi Morimoto32, Takeshi Kimura33, Satoshi Shizuta33. 1. Division of Cardiology, Japanese Red Cross Otsu Hospital, Otsu 520-8511, Japan; Department of Cardiology, Tenri Hospital, Tenri 632-0015, Japan. 2. Division of Cardiology, Japanese Red Cross Otsu Hospital, Otsu 520-8511, Japan; Department of Cardiology, Tenri Hospital, Tenri 632-0015, Japan. Electronic address: kaitani@mti.biglobe.ne.jp. 3. Department of Cardiology, Tenri Hospital, Tenri 632-0015, Japan; Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu 520-2192, Japan. 4. Cardiovascular Center, Sakurabashi Watanabe Hospital, Osaka 530-0001, Japan; Division of Cardiology, National Hospital Organization Osaka Medical Center, Osaka 540-0006, Japan. 5. Division of Cardiology, Kobe City Medical Center General Hospital, Kobe 650-0047, Japan. 6. Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu 520-2192, Japan. 7. Cardiovascular Center, Namba Kurotobi Heart Clinic, Osaka 542-0076, Japan. 8. Department of Cardiology, Ogaki Municipal Hospital, Ogaki 503-8502, Japan. 9. Department of Cardiology, Hiroshima Prefectural Hospital, Hiroshima 734-8530, Japan. 10. Division of Cardiology, Osaka General Medical Center, Osaka 558-8558, Japan. 11. Cardiovascular Center, Kansai Rosai Hospital, Amagasaki 660-8511, Japan. 12. Cardiovascular Center, Naito Hospital, Osaka 537-0002, Japan. 13. Department of Cardiovascular Medicine, Nara Prefecture Western Medical Center, Nara 636-0802, Japan. 14. Department of Cardiovascular Medicine, Nara Medical University, Kashihara 634-8522, Japan. 15. Department of Cardiovascular Medicine, Ichinomiya Nishi Hospital, Ichinomiya 494-0001, Japan. 16. Department of Cardiovascular Medicine, Omihachiman Community Medical Center, Omihachiman 523-0082, Japan. 17. Department of Cardiology, JCHO Kobe Central Hospital, Kobe 651-1145, Japan. 18. Department of Cardiology, Kakogawa Central City Hospital, Kakogawa 675-8611, Japan. 19. Faculty of Human Sciences, Osaka University of Economics, Osaka 533-8533, Japan. 20. Division of Cardiology, Osaka Rosai Hospital, Osaka 591-8025, Japan. 21. Department of Cardiology, Tokyo Medical University, Tokyo 160-0023, Japan. 22. Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan. 23. Cardiovascular Center, Tazuke Medical Research Institute Kitano Hospital, Osaka 530-8480, Japan. 24. Department of Cardiovascular Medicine, Okamura Memorial Hospital, Shizuoka 411-0904, Japan. 25. Cardiovascular Center, Ito Medical Clinic, Kusatsu 525-0037, Japan. 26. Department of Cardiovascular Medicine, Nippon Medical School, Tokyo 113-8603, Japan. 27. Department of Cardiology, Mahoshi Hospital, Kobe 651-1242, Japan. 28. Department of Cardiology, Tenri Hospital, Tenri 632-0015, Japan; Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki 660-8550, Japan. 29. Department of Cardiology, Tenri Hospital, Tenri 632-0015, Japan; Department of Cardiology, Japanese Red Cross Society Wakayama Medical Center, Wakayama 640-8558, Japan. 30. Department of Cardiology, Tenri Hospital, Tenri 632-0015, Japan. 31. Department of Cardiology, Tenri Hospital, Tenri 632-0015, Japan; Division of Heart Failure, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan. 32. Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya 663-8501, Japan. 33. Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan.
Abstract
BACKGROUND: The relationship between the timing of the first early recurrence and late recurrence after a single catheter ablation procedure for atrial fibrillation is controversial. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
BACKGROUND: The relationship between the timing of the first early recurrence and late recurrence after a single catheter ablation procedure for atrial fibrillation is controversial. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Authors: Filippo Cacioppo; Michael Schwameis; Nikola Schuetz; Julia Oppenauer; Sebastian Schnaubelt; Alexander Simon; Martin Lutnik; Sophie Gupta; Dominik Roth; Harald Herkner; Alexander Oskar Spiel; Anton Norbert Laggner; Hans Domanovits; Jan Niederdoeckl Journal: Int J Environ Res Public Health Date: 2022-05-28 Impact factor: 4.614