Repeat ablation timing for recurrent atrial fibrillation: A prospective study.

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.