Abstract
ObjectivesOne of the mechanisms of early recurrence of atrial fibrillation (ERAF) after AF ablation is considered to be the inflammatory reaction of the atrial tissue. The aim of this study is to compare the clinical significance of ERAF at each stage for true AF recurrence between cryoballoon (CB) and radiofrequency (RF) ablation.MethodsAmong 798 paroxysmal AF patients who underwent an initial ablation, 460 patients (CB, n = 230; RF, n = 230) were selected by propensity score matching. Very ERAF (VERAF), ERAF-1M, ERAF-3M and true AF recurrence were defined as AF recurrence at 0–2, 3–30, 31–90 days and more than 90 days after the procedure, respectively.ResultsThe patient characteristics of the two groups were similar. ERAF was observed 21% and 27% in the CB and RF groups, respectively. In both the CB and RF group, VERAF, ERAF-1M and ERAF-3M were more frequently observed in patients with true AF recurrence than in those without. In a multivariable analysis, ERAF-1M and ERAF-3M were found to be independent predictors of true AF recurrence in both the CB (P = 0.04 and P<0.001, respectively) and RF groups (P = 0.02 and P = 0.001, respectively). However, while VERAF was associated with true AF recurrence after RF ablation (P = 0.03), it was not associated with true AF recurrence after CB ablation (P = 0.19).ConclusionThe relationship between ERAF and true AF recurrence differed between the RF and CB ablation groups. While VERAF was associated with true AF recurrence after RF ablation, it was not a predictor of true AF recurrence after CB ablation.
Highlights
Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation for atrial fibrillation (AF), especially in paroxysmal AF patients [1]
Very early recurrence of AF (ERAF) (VERAF), ERAF-1M, ERAF-3M and true AF recurrence were defined as AF recurrence at 0–2, 3–30, 31–90 days and more than 90 days after the procedure, respectively
ERAF was observed 21% and 27% in the CB and RF groups, respectively. In both the CB and RF group, VERAF, ERAF1M and ERAF-3M were more frequently observed in patients with true AF recurrence than in those without
Summary
Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation for atrial fibrillation (AF), especially in paroxysmal AF patients [1]. One of mechanisms of early recurrence of AF (ERAF) is considered to be a transient phenomenon due to the inflammatory reaction of atrial tissue. Because of the significant associations between ERAF and late AF recurrence after RF [4] or CB [6,7,8] ablation, and the difference in the inflammatory reactions observed immediately after and months after ablation, the definition of the blanking period should be reconsidered. The clinical significance of ERAF in each stage during the blanking period may differ between CB and RF ablation. The aim of this study is to compare the clinical significance of ERAF at each stage for true AF recurrence between CB and RF ablation
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