Clinical Predictors Of Late Recurrence In Patients With Atrial Fibrillation After Transcatheter Ablation

ObjectiveThis study aimed to find the clinical predictors of late recurrence of atrial fibrillation（AF）after the restoration of sinus rhythm by catheter ablation（CA）in patients with AF.CA is an effective therapy for rhythm control in patients with AF.by restoring normal cardiac rhythm.CA not only prevents left atrial thrombosis and secondary cardiogenic thromboembolism events,but also improves cardiac function in patients with AF.However,not all patients with AF can maintain sinus rhythm for a long time after CA,and 20%-50% of patients still have AF late recurrence.At present,there is no consistent independent predictor in predicting AF late recurrence after CA.Therefore,identifying patients reasonably and accurately with high recurrence risk is of great significance to the management of patients,especially the formulation of individualized treatment plan.MethodsThe clinical data of AF patients accepting CA in China-Japan United Hospital of Jilin University,from June,2020 to September,2021,were collected and analyzed.AF late recurrence was defined as any tachyarrhythmia（including short array atrial tachycardia,atrial flutter,AF）recorded by ECG or Holter recording lasting more than 30 seconds after the procedure more than 3 months.ResultsA total of 82 patients underwent CA.Late recurrence occurred in 13patients（15.9%）.Patients who experienced late recurrence had at least one of the following risk factors,including female,persistent AF,heart failure,high NT-pro BNP level,E and E/e’ measured higher in echocardiogram examination.According to the Cox ratio risk model,E/e’is an independent predictor of late recurrence after CA.In the receiver operating curve（ROC）,patients with E/e’ ≥ 17.60（HR = 1.252,95% CI:1.065 ～ 1.472,P = 0.007）are more likely to have late AF recurrence after CA.ConclusionAmong the clinical factors predicting the late recurrence of AF after CA,women,persistent AF,and heart failure are of great significance;E/e’is an independent predictor of late recurrence of AF after CA,and patients with E/e’≥ 17.60 are more likely to have a late recurrence.