Risk Factors for Recurrence of Atrial Fibrillation within 3 Years after Radiofrequency Ablation
DOI:
https://doi.org/10.59958/hsf.7947Keywords:
atrial fibrillation, radiofrequency ablation, recurrence, risk factorsAbstract
Background: Atrial fibrillation is chronic cardiovascular disease, particularly in older patients. Radiofrequency ablation can successfully treat this condition and restore sinus rhythm. However, the postoperative recurrence rate is relatively high. This investigation aimed to address the factors that might increase the risk of recurrence after radiofrequency ablation. Methods: We studied patients who had a successful radiofrequency ablation in our center between 2017 and 2020. We collected information about these patients before the procedure, including their age, sex, obesity, medical history, preoperative laboratory test results, and cardiac ultrasound findings. We divided patients into two groups: those who had atrial fibrillation again within three years and those who did not. We compared the information we collected about these two groups to see if there were any differences to explain why some people had atrial fibrillation again and others did not. We used a statistical method called multivariate logistic regression to analyze these data. Results: After reviewing the patients based on specific criteria, we included 297 patients in our final analysis. Within three years after surgery, 109 patients (36.7%) had a recurrence, whereas 188 (63.3%) did not. When we compared the two groups, we found that older patients, those with obesity, a longer history of atrial fibrillation, a larger left atrium, persistent atrial fibrillation, and higher levels of C-reactive protein before surgery were likely to have atrial fibrillation again within three years (p < 0.05). Our statistical analysis revealed that these factors were independent predictors of atrial fibrillation recurrence. Conclusions: Age, obesity, duration of atrial fibrillation, the size of left atrium, the type of atrial fibrillation, and C-reactive protein (CRP) levels before surgery are closely related to atrial fibrillation recurrence within 3 years after radiofrequency ablation.
References
Schnabel RB, Yin X, Gona P, Larson MG, Beiser AS, McManus DD, et al. 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study. Lancet. 2015; 386: 154–162.
Li H, Song X, Liang Y, Bai X, Liu-Huo WS, Tang C, et al. Global, regional, and national burden of disease study of atrial fibrillation/flutter, 1990-2019: results from a global burden of disease study, 2019. BMC Public Health. 2022; 22: 2015.
Liu S, Li Y, Zeng X, Wang H, Yin P, Wang L, et al. Burden of Cardiovascular Diseases in China, 1990-2016: Findings From the 2016 Global Burden of Disease Study. JAMA Cardiology. 2019; 4: 342–352.
Wijesurendra RS, Casadei B. Mechanisms of atrial fibrillation. Heart. 2019; 105: 1860–1867.
Hu Z, Ding L, Yao Y. Atrial fibrillation: mechanism and clinical management. Chinese Medical Journal. 2023; 136: 2668–2676.
Brundel BJJM, Ai X, Hills MT, Kuipers MF, Lip GYH, de Groot NMS. Atrial fibrillation. Nature Reviews. Disease Primers. 2022; 8: 21.
January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC, Jr, et al. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients with Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in Collaboration With the Society of Thoracic Surgeons. Circulation. 2019; 140: e125–e151.
Milman B, Burns BD. Atrial fibrillation: an approach to diagnosis and management in the emergency department. Emergency Medicine Practice. 2021; 23: 1–28.
Steffel J, Verhamme P, Potpara TS, Albaladejo P, Antz M, Desteghe L, et al. The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. European Heart Journal. 2018; 39: 1330–1393.
Alrumayh A, Alobaida M. Catheter ablation superiority over the pharmacological treatments in atrial fibrillation: a dedicated review. Annals of Medicine. 2021; 53: 551–557.
Parameswaran R, Al-Kaisey AM, Kalman JM. Catheter ablation for atrial fibrillation: current indications and evolving technologies. Nature Reviews. Cardiology. 2021; 18: 210–225.
Vrachatis DA, Papathanasiou KA, Kossyvakis C, Kazantzis D, Giotaki SG, Deftereos G, et al. Early arrhythmia recurrence after cryoballoon ablation in atrial fibrillation: A systematic review and meta-analysis. Journal of Cardiovascular Electrophysiology. 2022; 33: 527–539.
Hodges G, Bang CN, Torp-Pedersen C, Hansen ML, Schjerning AM, Hansen J, et al. Significance of early recurrence of atrial fibrillation after catheter ablation: a nationwide Danish cohort study. Journal of Interventional Cardiac Electrophysiology. 2021; 60: 271–278.
Li Z, Wang S, Hidru TH, Sun Y, Gao L, Yang X, et al. Long Atrial Fibrillation Duration and Early Recurrence Are Reliable Predictors of Late Recurrence After Radiofrequency Catheter Ablation. Frontiers in Cardiovascular Medicine. 2022; 9: 864417.
Peng Z, Wen-Heng L, Qing Z, Pin S, Shang-Lang C, Mao-Jing W, et al. Risk factors for late recurrence in patients with nonvalvular atrial fibrillation after radiofrequency catheter ablation. Annals of Noninvasive Electrocardiology. 2022; 27: e12924.
Choi SH, Yu HT, Kim D, Park JW, Kim TH, Uhm JS, et al. Late recurrence of atrial fibrillation 5 years after catheter ablation: predictors and outcome. Europace. 2023; 25: euad113.
Cai L, Yin Y, Ling Z, Su L, Liu Z, Wu J, et al. Predictors of late recurrence of atrial fibrillation after catheter ablation. International Journal of Cardiology. 2013; 164: 82–87.
Zink MD, Chua W, Zeemering S, di Biase L, Antoni BDL, David C, et al. Predictors of recurrence of atrial fibrillation within the first 3 months after ablation. Europace. 2020; 22: 1337–1344.
Duytschaever M, De Potter T, Grimaldi M, Anic A, Vijgen J, Neuzil P, et al. Paroxysmal Atrial Fibrillation Ablation Using a Novel Variable-Loop Biphasic Pulsed Field Ablation Catheter Integrated With a 3-Dimensional Mapping System: 1-Year Outcomes of the Multicenter inspIRE Study. Circulation. Arrhythmia and Electrophysiology. 2023; 16: e011780.
Shah AN, Mittal S, Sichrovsky TC, Cotiga D, Arshad A, Maleki K, et al. Long-term outcome following successful pulmonary vein isolation: pattern and prediction of very late recurrence. Journal of Cardiovascular Electrophysiology. 2008; 19: 661–667.
Weerasooriya R, Khairy P, Litalien J, Macle L, Hocini M, Sacher F, et al. Catheter ablation for atrial fibrillation: are results maintained at 5 years of follow-up? Journal of the American College of Cardiology. 2011; 57: 160–166.
Wokhlu A, Hodge DO, Monahan KH, Asirvatham SJ, Friedman PA, Munger TM, et al. Long-term outcome of atrial fibrillation ablation: impact and predictors of very late recurrence. Journal of Cardiovascular Electrophysiology. 2010; 21: 1071–1078.
Beyer C, Tokarska L, Stühlinger M, Feuchtner G, Hintringer F, Honold S, et al. Structural Cardiac Remodeling in Atrial Fibrillation. JACC. Cardiovascular Imaging. 2021; 14: 2199–2208.
MacGregor RM, Khiabani AJ, Bakir NH, Kelly MO, Perez SC, Maniar HS, et al. Impact of Obesity on Atrial Fibrillation Recurrence Following Stand-Alone Cox Maze IV Procedure. Innovations. 2021; 16: 434–440.
Pisani CF, Scanavacca M. Obesity and Epicardial Fat Associated with Higher Atrial Fibrillation Recurrence After Ablation: Just Coincidence? Arquivos Brasileiros De Cardiologia. 2022; 118: 743–744.
Pranata R, Henrina J, Yonas E, Putra ICS, Cahyadi I, Lim MA, et al. BMI and atrial fibrillation recurrence post catheter ablation: A dose-response meta-analysis. European Journal of Clinical Investigation. 2021; 51: e13499.
Chew DS, Black-Maier E, Loring Z, Noseworthy PA, Packer DL, Exner DV, et al. Diagnosis-to-Ablation Time and Recurrence of Atrial Fibrillation Following Catheter Ablation: A Systematic Review and Meta-Analysis of Observational Studies. Circulation. Arrhythmia and Electrophysiology. 2020; 13: e008128.
Vizzardi E, Curnis A, Latini MG, Salghetti F, Rocco E, Lupi L, et al. Risk factors for atrial fibrillation recurrence: a literature review. Journal of Cardiovascular Medicine. 2014; 15: 235–253.
D'Ascenzo F, Corleto A, Biondi-Zoccai G, Anselmino M, Ferraris F, di Biase L, et al. Which are the most reliable predictors of recurrence of atrial fibrillation after transcatheter ablation?: a meta-analysis. International Journal of Cardiology. 2013; 167: 1984–1989.
Nagai T, Anzai T, Kaneko H, Mano Y, Anzai A, Maekawa Y, et al. C-reactive protein overexpression exacerbates pressure overload-induced cardiac remodeling through enhanced inflammatory response. Hypertension. 2011; 57: 208–215.
Watanabe T, Takeishi Y, Hirono O, Itoh M, Matsui M, Nakamura K, et al. C-reactive protein elevation predicts the occurrence of atrial structural remodeling in patients with paroxysmal atrial fibrillation. Heart and Vessels. 2005; 20: 45–49.
Published
How to Cite
Issue
Section
Copyright (c) 2024 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
