Predictive value of early recurrence and delayed cure after catheter ablation for patients with chronic atrial fibrillation.

BACKGROUND: Radiofrequency catheter ablation (RFCA) for curing atrial fibrillation (AF) is often followed by early recurrence and delayed cure, so the present study investigate the predictive factors this in patients with chronic AF.

METHODS AND RESULTS: Ninety-two consecutive patients (70 males; mean age, 58.7+/-6.4 years) with chronic AF who underwent RFCA for treatment of symptomatic AF were enrolled. Early recurrence of AF (ERAF) occurred in 45 patients after ablation. Not achieving AF termination could predict ERAF (odds ratio (OR) 0.95; 95% confidence interval (CI) 0.84-1.13; p=0.02) in multivariate analysis. During a follow-up of 12+/-11 (range, 5-25) months, delayed cure occurred in 35.6% (16/45) of the patients with ERAF. Left atrial size and AF termination during ablation were related to delayed cure. AF termination was the only independent predictive factor for delayed cure (OR 1.47; 95% CI 1.05-1.87; p=0.02).

CONCLUSION: Not achieving AF termination is the only independent predictor of ERAF. Among patients with ERAF, those with a smaller left atrium and AF termination have a higher probability of delayed cure. AF termination can independently predict delayed cure. These results emphasize the importance of AF termination during ablation for patients with chronic AF.