Characterisation of ablation strategies at redo catheter ablation for atrial fibrillation and predictors of arrhythmia recurrence: results from the AFREDO registry

• DOI: 10.1093/europace/euae102.101
• Publication Date: 2024-05-24T12:20:53Z
• Authors: J Hoevelmann; A Kiehm; C A Viljoen; V Pavlicek; M Boehm; C Ukena
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Arrhythmias and device therapy

Abstract Background Patients who have undergone prior pulmonary vein isolation (PVI) for atrial fibrillation (AF) often require a repeat ablation AF recurrence. The optimal ablative strategy the redo procedure and predictors of recurrence thereafter remain largely unknown. Purpose We aimed to characterise strategies applied at re-PVI identify possible Methods Our single-centre, retrospective study included all consecutive patients underwent first PVI our centre from 2017 2022. Inclusion criteria required least one available follow-up visit within 12 months after procedure. Ablation initial were captured. Kaplan-Meier curves used illustrate time recurrence, as classified by outcome determined multivariable regression analyses. Results 215 (39.1% female) with median age 66.6 years (IQR 58.6-73.2) was cryoablation in 39.9%, RFA 57.7% surgical 2.4%. After procedure, 55.8% had paroxysmal 44.2% persistent AF. At 25.1% found no PV reconnection, whereas 20.5% single reconnected PV, 54.4% two or more PVs. A left-sided flutter performed 18.8%, left (LA) roof line 16.9%, posterior mitral isthmus 5.2%, an anterior 27.9%, box lesion 8.4%. Overall, 34.4% showed areas low-voltages low voltages less likely any PVs redo-procedure (p<0.001). second 54.0% experienced Univariable analysis revealed moderate (p=0.006) severe (p= 0.015) LA dilatation, (p=0.005), voltage (p=0.011) significant number did not predict (p=0.1090). As illustrated Fig. 1 2, compared those (log-rank p=0.0025). Moreover, dilatation baseline associated frequent recurrences p=0.0279). Conclusion proportion undergoing that enlargement emerged Although reconnection observed than thirds re-PVI, it thereafter. However, without significantly low-voltage areas, which may be indicative different mechanism this subgroup.Figure 1:Type AFFigure 2:LA