PhD Scientific Days 2024

Cardiovascular Medicine and Research II.

Identification of parameters determining recurrence after atrial fibrillation ablation: Analysis of our three-year follow-up registry

Text of the abstract

Title: Identification of parameters determining recurrence after atrial fibrillation ablation: Analysis of our three-year follow-up registry

Introduction: Pulmonary vein isolation (PVI) is the most effective treatment for atrial fibrillation (AF). However, the long-term arrhythmia-free success rate varies widely.

Aims: Our study aimed to identify patient-specific and procedural parameters that can be used to predict long-term recurrence-free outcomes of AF ablation more accurately.

Methods: We collected data from patients who underwent PVI between 2010 and 2023. We analyzed the anthropometric data, comorbidities of the patients, as well as the procedural characteristics of the ablations. We also investigated the association of these parameters with recurrence within three years. Our data were evaluated using descriptive statistics, Shapiro-Wilk, Kruskal-Wallis, Dunn post-hoc, and Chi-square tests.

Results: Overall, 2349 patients (median age 63 (56-69) years, 33% female) were included in the study. Of these, 1099 (47%) patients developed AF recurrence during the study period. The median time from ablation to recurrence was 433 (155-981) days. Six hundred and seventeen patients (26%) had AF recurrence in the first year after intervention, 316 patients (14%) between the first and second year, and 166 patients (7%) between the second and third year. Hypertension (73% vs. 67%, p<0.001), valvular disease (4% vs. 3%, p<0.001), non-paroxysmal AF (40% vs. 26%, p<0.001), and AF as the initial rhythm at the beginning of the procedure (55% vs. 37%, p<0.001) were more common in recurrent patients compared to non-recurrent patients. Recurrences were less frequent in patients who were ablated with a steerable sheath (73% vs. 68%, p<0.001) and those who received NOAC therapy (67% vs. 41%, p=0.004).

Conclusion: Hypertension, valvular disease, non-paroxysmal AF, and AF as the initial rhythm at the beginning of the procedure may predict recurrence. In contrast, the use of steerable sheath and NOAC therapy may predict long-term recurrence-free outcomes. We plan to characterize the associations by further statistical analyses.

Funding: ÚNKP-23-3-II-SE-69; MD-PhD Excellence Program: EFOP-3.6.3-VEKOP-16-2017-00009; Gedeon Richter Excellence PhD Scholarship of Gedeon Richter