Risk Factors for Late Recurrence in Patients with Nonvalvular Atrial Fibrillation After Radiofrequency Catheter Ablation

Overview

Journal Ann Noninvasive Electrocardiol

Specialty Cardiology & Vascular Diseases

Date 2021 Dec 9

PMID 34882911

Citations 6

Authors

Zhang Peng

Liu Wen-Heng

Zhao Qing

Sun Pin

Cai Shang-Lang

Wang Mao-Jing

Pan Ya-Qi

Affiliations

Soon will be listed here.

Abstract

Objective: To identify the risk factors for postoperative atrial fibrillation (AF) recurrence in nonvalvular AF patients undergoing radiofrequency catheter ablation (CA).

Methods: We retrospectively reviewed the data from 426 of 450 AF patients who underwent CA. Patients were divided into two groups according to recurrence after the operation; the risk factors for AF recurrence were analyzed. A stratification system for lesions was created based on the cutoff of the risk factors; the associations among the subgroups and the AF recurrence rate were analyzed.

Results: AF recurrence occurred in 98 (23.0%) patients. Univariate analysis demonstrated that AF type, hypertrophic cardiomyopathy, left atrial diameter (LAD), left ventricular ejection fraction (LVEF), serum albumin, and D-dimer concentrations were associated with AF recurrence. AF type (OR =2.907, p < .001), serum albumin concentration (OR =1.112, p < .05), and LAD (OR =1.115, p < .001) were independent risk factors for AF recurrence. The area under the ROC curve of LAD for the prediction of AF recurrence was 0.722 (95% CI: 0.664~0.779) and that of serum albumin for the prediction of AF recurrence was 0.608 (95% CI: 0.545~0.672). Further stratification revealed that patients with persistent or paroxysmal AF with LAD ≥43.5 mm and serum albumin concentration ≥42.2 g/L had a higher rate of AF recurrence than the reference group.

Conclusion: Atrial fibrillation type, LAD, and serum albumin concentration are risk factors for AF recurrence after CA in patients with nonvalvular AF. Patients with persistent AF with LAD ≥43.5 mm and serum albumin concentration ≥42.2 g/L have a higher risk of late AF recurrence after surgery.

Citing Articles

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References

DAscenzo F, Corleto A, Biondi-Zoccai G, Anselmino M, FERRARIS F, Di Biase L . Which are the most reliable predictors of recurrence of atrial fibrillation after transcatheter ablation?: a meta-analysis. Int J Cardiol. 2012; 167(5):1984-9. DOI: 10.1016/j.ijcard.2012.05.008. View

Lee K, Kim B, Han M, Kim J, Choi K, Shin D . Effect of Heart Rate on Stroke Recurrence and Mortality in Acute Ischemic Stroke With Atrial Fibrillation. Stroke. 2019; 51(1):162-169. DOI: 10.1161/STROKEAHA.119.026847. View

Steinberg J, Palekar R, Sichrovsky T, Arshad A, Preminger M, Musat D . Very long-term outcome after initially successful catheter ablation of atrial fibrillation. Heart Rhythm. 2014; 11(5):771-6. DOI: 10.1016/j.hrthm.2014.02.003. View

Pranata R, Chintya V, Raharjo S, Yamin M, Yuniadi Y . Longer diagnosis-to-ablation time is associated with recurrence of atrial fibrillation after catheter ablation-Systematic review and meta-analysis. J Arrhythm. 2020; 36(2):289-294. PMC: 7132183. DOI: 10.1002/joa3.12294. View

Poole J, Bahnson T, Monahan K, Johnson G, Rostami H, Silverstein A . Recurrence of Atrial Fibrillation After Catheter Ablation or Antiarrhythmic Drug Therapy in the CABANA Trial. J Am Coll Cardiol. 2020; 75(25):3105-3118. PMC: 8064404. DOI: 10.1016/j.jacc.2020.04.065. View

Lee H, Hwang Y, Chang P, Wen M, Chou C . A three-year longitudinal study of the relation between left atrial diameter remodeling and atrial fibrillation ablation outcome. J Geriatr Cardiol. 2018; 15(7):486-491. PMC: 6198265. DOI: 10.11909/j.issn.1671-5411.2018.07.005. View

Hindricks G, Potpara T, Dagres N, Arbelo E, Bax J, Blomstrom-Lundqvist C . 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the.... Eur Heart J. 2020; 42(5):373-498. DOI: 10.1093/eurheartj/ehaa612. View

Zheng J, Zu D, Cheng K, Xia Y, Dong Y, Gao Z . Decreased estimated glomerular filtration rate predicts long-term recurrence after catheter ablation of atrial fibrillation in mild to moderate renal insufficiency. BMC Cardiovasc Disord. 2021; 21(1):508. PMC: 8529753. DOI: 10.1186/s12872-021-02320-y. View

Hindricks G, Sepehri Shamloo A, Lenarczyk R, Kalarus Z, Arya A, Kircher S . Catheter ablation of atrial fibrillation: current status, techniques, outcomes and challenges. Kardiol Pol. 2018; 76(12):1680-1686. DOI: 10.5603/KP.a2018.0216. View

10.

Liao L, Zhang S, Li W, Liu Y, Li J, Zhuang X . Serum albumin and atrial fibrillation: insights from epidemiological and mendelian randomization studies. Eur J Epidemiol. 2019; 35(2):113-122. DOI: 10.1007/s10654-019-00583-6. View

11.

Pluymaekers N, Dudink E, Luermans J, Meeder J, Lenderink T, Widdershoven J . Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation. N Engl J Med. 2019; 380(16):1499-1508. DOI: 10.1056/NEJMoa1900353. View

12.

Packer D, Mark D, Robb R, Monahan K, Bahnson T, Poole J . Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial. JAMA. 2019; 321(13):1261-1274. PMC: 6450284. DOI: 10.1001/jama.2019.0693. View

13.

Peng Z, Wen-Heng L, Qing Z, Pin S, Shang-Lang C, Mao-Jing W . Risk factors for late recurrence in patients with nonvalvular atrial fibrillation after radiofrequency catheter ablation. Ann Noninvasive Electrocardiol. 2021; 27(2):e12924. PMC: 8916568. DOI: 10.1111/anec.12924. View

14.

Wang T, Xia Y, Zhang S, Gao L, Xie Z, Yang Y . The impact of hypertension on the electromechanical properties and outcome of catheter ablation in atrial fibrillation patients. J Thorac Dis. 2014; 6(7):913-20. PMC: 4120167. DOI: 10.3978/j.issn.2072-1439.2014.06.31. View

15.

Anselmino M, Matta M, DAscenzo F, Pappone C, Santinelli V, Bunch T . Catheter ablation of atrial fibrillation in patients with diabetes mellitus: a systematic review and meta-analysis. Europace. 2015; 17(10):1518-25. DOI: 10.1093/europace/euv214. View

16.

Cappato R, Calkins H, Chen S, Davies W, Iesaka Y, Kalman J . Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circ Arrhythm Electrophysiol. 2009; 3(1):32-8. DOI: 10.1161/CIRCEP.109.859116. View

17.

Voskoboinik A, Kalman J, De Silva A, Nicholls T, Costello B, Nanayakkara S . Alcohol Abstinence in Drinkers with Atrial Fibrillation. N Engl J Med. 2020; 382(1):20-28. DOI: 10.1056/NEJMoa1817591. View

18.

Vinter N, Huang Q, Fenger-Gron M, Frost L, Benjamin E, Trinquart L . Trends in excess mortality associated with atrial fibrillation over 45 years (Framingham Heart Study): community based cohort study. BMJ. 2020; 370:m2724. PMC: 7418071. DOI: 10.1136/bmj.m2724. View

19.

Teh A, Kistler P, Lee G, Medi C, Heck P, Spence S . Electroanatomic remodeling of the left atrium in paroxysmal and persistent atrial fibrillation patients without structural heart disease. J Cardiovasc Electrophysiol. 2011; 23(3):232-8. DOI: 10.1111/j.1540-8167.2011.02178.x. View

20.

Dagres N, Varounis C, Gaspar T, Piorkowski C, Eitel C, Iliodromitis E . Catheter ablation for atrial fibrillation in patients with left ventricular systolic dysfunction. A systematic review and meta-analysis. J Card Fail. 2011; 17(11):964-70. DOI: 10.1016/j.cardfail.2011.07.009. View