Heart rhythm · 2025
Repeat ablation timing for recurrent atrial fibrillation: A prospective study.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Wang Shiyi, Song Ziliang, Guo Jiongchao, Liu Yang, Wu Shaohui, Jiang Weifeng, Zhang Feng, Chen Nannan, Liu Xu, Hou Xumin, Qin Mu
Аннотация
BACKGROUND: The optimal timing for repeat ablation in patients with recurrent atrial fibrillation (AF) remains unclear owing to a lack of previous studies. Therefore, we conducted a multicenter prospective study to evaluate whether the time from AF diagnosis recurrence to repeat ablation influences procedural outcomes.
OBJECTIVES: This study aimed to identify the optimal timing for repeat ablation in patients with recurrent AF.
METHODS: This prospective cohort study enrolled 1144 patients with recurrent AF from 3 hospitals in China between January 2019 and December 2022. Patients were stratified into 4 groups on the basis of quartiles of the AF diagnosis-recurrence-to-ablation time (DRAT). The primary end point was freedom from AF/atrial tachycardia (AT) recurrence at 12 months.
RESULTS: The quartile groups were as follows: Q1, DRAT 0-12 months (n = 287; median DRAT 7 months); Q2, DRAT 13-33 months (n = 292; median DRAT 23 months); Q3, DRAT 34-56 months (n = 280; median DRAT 44 months); and Q4, DRAT ≥ 57 months (n = 285; median DRAT 82 months). At 12 months, the rates of freedom from AF/AT recurrence were 71.0%, 61.7%, 61.6%, and 54.7% in Q1-Q4, respectively (P < .001). The lowest AF/AT recurrence was achieved in Q1, with a gradual decline in success rate with increasing DRAT.
CONCLUSION: Our findings indicate that shorter DRAT is associated with lower AF/AT recurrence, suggesting early repeat ablation (particularly within 12 months) as a potential strategy for improving outcomes in patients with recurrent AF.
OBJECTIVES: This study aimed to identify the optimal timing for repeat ablation in patients with recurrent AF.
METHODS: This prospective cohort study enrolled 1144 patients with recurrent AF from 3 hospitals in China between January 2019 and December 2022. Patients were stratified into 4 groups on the basis of quartiles of the AF diagnosis-recurrence-to-ablation time (DRAT). The primary end point was freedom from AF/atrial tachycardia (AT) recurrence at 12 months.
RESULTS: The quartile groups were as follows: Q1, DRAT 0-12 months (n = 287; median DRAT 7 months); Q2, DRAT 13-33 months (n = 292; median DRAT 23 months); Q3, DRAT 34-56 months (n = 280; median DRAT 44 months); and Q4, DRAT ≥ 57 months (n = 285; median DRAT 82 months). At 12 months, the rates of freedom from AF/AT recurrence were 71.0%, 61.7%, 61.6%, and 54.7% in Q1-Q4, respectively (P < .001). The lowest AF/AT recurrence was achieved in Q1, with a gradual decline in success rate with increasing DRAT.
CONCLUSION: Our findings indicate that shorter DRAT is associated with lower AF/AT recurrence, suggesting early repeat ablation (particularly within 12 months) as a potential strategy for improving outcomes in patients with recurrent AF.