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Early Recurrences after Paroxysmal Atrial Fibrillation Ablation: When is the Proper Timing for Reablation?
Author(s) -
WANG XINHUA,
LIU XU,
SHI HAIFENG,
TAN HONGWEI,
JIANG WEIFENG,
WANG YUANLONG,
YANG GUOSHU,
ZHOU LI
Publication year - 2011
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2010.03023.x
Subject(s) - medicine , atrial fibrillation , atrial flutter , pulmonary vein , ablation , cardiology , paroxysmal atrial fibrillation , catheter ablation , surgery
Background: Early recurrences (ERs) within 1 month after paroxysmal atrial fibrillation (AF) ablation are common and may subside in a considerable proportion of patients. Although late reablation after 3 months is recommended, the proper timing for reablation remains undetermined.Methods and Results: One hundred and seventeen (31.2%) from the pool of 375 patients experienced ERs at 7.5 ± 5.5 days postablation. They were allocated into two groups randomly: early reablation group (ERe+) (n = 57) and nonearly reablation group (ERe−) (n = 60). Forty patients (70.2%) in ERe+ group underwent early reablation at 28.1 ± 2.7 days postablation. Forty patients (66.7%) in ERe− group underwent late reablation at 98.2 ± 5.2 days postablation. The proportion of reablation was comparable (P = 0.68). ERs subsided in 17 (29.8%) in ERe+ group and in 20 (33.3%) in ERe− group. In ERe+ group, PV reconnection in 36 (80.0%), non‐PV foci in six (10.5%), and right or left atrial flutter in five (8.8%) was abolished by ablation . In ERe− group, pulmonary vein (PV) reconnection in 29 (72.5%), non‐PV foci in eight (13.3%), and right or left atrial flutter in eight (13.3%) was ablated successfully. The proportion of PV reconnection, nonfoci, and atrial flutter was comparable, P = 0.45, 0.64, and 0.56, respectively. At the end of 16.5 ± 2.0 (ERe+ group) and 15.2 ± 2.6 (ERe− group) months’ follow‐up, 47 (82.5%) in ERe+ group and 51 (85%) in ERe− group were free of atrial tachyarrhythmias, P = 0.70.Conclusions: Compared with reablation 2 months later after initial ablation, early reablation at ≈1 month had similar clinical effectiveness. The proper timing for reablation can be set at ≈1 month after initial paroxysmal AF ablation. (PACE 2011; 709–716)