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Significance of early recurrence of atrial fibrillation after catheter ablation: a nationwide Danish cohort study

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@article{0c1c85f7543342fbadfbbc588a33af2a,
title = "Significance of early recurrence of atrial fibrillation after catheter ablation: a nationwide Danish cohort study",
abstract = "BACKGROUND: Recurrence of atrial tachyarrhythmias after ablation of atrial fibrillation (AF) is common, although consensus guidelines advise against immediate re-ablation of {"}early recurrences{"} (occurring ≤ 90 days after ablation). However, recent studies show early recurrence is associated with {"}late recurrence{"} (occurring > 90 days) and question the duration of this {"}blanking period.{"} We investigated incidence and timing of early recurrence in relation to late recurrence in a large nationwide cohort.METHODS: From Danish nationwide registers, we included all patients aged 18 and older who underwent first-time ablation for AF between January 2005 and April 2017 and followed them for up to 2 years.RESULTS: Of the total 7339 patients included (72% male; median age 62 years), 2801 (38%) experienced early recurrence. The odds of late recurrence were 2.34 times higher (95% confidence interval, 2.09-2.63; P < 0.001) given early recurrence, compared with those without early recurrence. In particular, both timing and frequency of early recurrences were associated with a significantly higher odds of late recurrence in a graded relationship: odds ratio (OR) 2.08/4.96/6.25 for early recurrences in the first/second/third month respectively (all P < 0.001); and OR 1.64/2.83/5.14 for those experiencing one/two/more than two episodes respectively (all P < 0.001); compared with those without early recurrence.CONCLUSION: In patients undergoing first-time ablation for AF, both the frequency and later onset of early recurrence are significantly associated with higher odds of late recurrence. This suggests the arbitrary blanking period should be abandoned in favor of a case-by-case assessment when evaluating candidates for re-ablation.",
keywords = "Ablation, Atrial fibrillation, Blanking period",
author = "Gethin Hodges and Bang, {Casper N} and Christian Torp-Pedersen and Hansen, {Morten Lock} and Anne-Marie Schjerning and Jim Hansen and Arne Johannessen and Gislason, {Gunnar H} and Jannik Pallisgaard",
note = "Publisher Copyright: {\textcopyright} 2020, Springer Science+Business Media, LLC, part of Springer Nature. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = mar,
doi = "10.1007/s10840-020-00741-x",
language = "English",
volume = "60",
pages = "271--278",
journal = "Journal of Interventional Cardiac Electrophysiology",
issn = "1383-875X",
publisher = "Springer New York LLC",
number = "2",

}

RIS

TY - JOUR

T1 - Significance of early recurrence of atrial fibrillation after catheter ablation

T2 - a nationwide Danish cohort study

AU - Hodges, Gethin

AU - Bang, Casper N

AU - Torp-Pedersen, Christian

AU - Hansen, Morten Lock

AU - Schjerning, Anne-Marie

AU - Hansen, Jim

AU - Johannessen, Arne

AU - Gislason, Gunnar H

AU - Pallisgaard, Jannik

N1 - Publisher Copyright: © 2020, Springer Science+Business Media, LLC, part of Springer Nature. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/3

Y1 - 2021/3

N2 - BACKGROUND: Recurrence of atrial tachyarrhythmias after ablation of atrial fibrillation (AF) is common, although consensus guidelines advise against immediate re-ablation of "early recurrences" (occurring ≤ 90 days after ablation). However, recent studies show early recurrence is associated with "late recurrence" (occurring > 90 days) and question the duration of this "blanking period." We investigated incidence and timing of early recurrence in relation to late recurrence in a large nationwide cohort.METHODS: From Danish nationwide registers, we included all patients aged 18 and older who underwent first-time ablation for AF between January 2005 and April 2017 and followed them for up to 2 years.RESULTS: Of the total 7339 patients included (72% male; median age 62 years), 2801 (38%) experienced early recurrence. The odds of late recurrence were 2.34 times higher (95% confidence interval, 2.09-2.63; P < 0.001) given early recurrence, compared with those without early recurrence. In particular, both timing and frequency of early recurrences were associated with a significantly higher odds of late recurrence in a graded relationship: odds ratio (OR) 2.08/4.96/6.25 for early recurrences in the first/second/third month respectively (all P < 0.001); and OR 1.64/2.83/5.14 for those experiencing one/two/more than two episodes respectively (all P < 0.001); compared with those without early recurrence.CONCLUSION: In patients undergoing first-time ablation for AF, both the frequency and later onset of early recurrence are significantly associated with higher odds of late recurrence. This suggests the arbitrary blanking period should be abandoned in favor of a case-by-case assessment when evaluating candidates for re-ablation.

AB - BACKGROUND: Recurrence of atrial tachyarrhythmias after ablation of atrial fibrillation (AF) is common, although consensus guidelines advise against immediate re-ablation of "early recurrences" (occurring ≤ 90 days after ablation). However, recent studies show early recurrence is associated with "late recurrence" (occurring > 90 days) and question the duration of this "blanking period." We investigated incidence and timing of early recurrence in relation to late recurrence in a large nationwide cohort.METHODS: From Danish nationwide registers, we included all patients aged 18 and older who underwent first-time ablation for AF between January 2005 and April 2017 and followed them for up to 2 years.RESULTS: Of the total 7339 patients included (72% male; median age 62 years), 2801 (38%) experienced early recurrence. The odds of late recurrence were 2.34 times higher (95% confidence interval, 2.09-2.63; P < 0.001) given early recurrence, compared with those without early recurrence. In particular, both timing and frequency of early recurrences were associated with a significantly higher odds of late recurrence in a graded relationship: odds ratio (OR) 2.08/4.96/6.25 for early recurrences in the first/second/third month respectively (all P < 0.001); and OR 1.64/2.83/5.14 for those experiencing one/two/more than two episodes respectively (all P < 0.001); compared with those without early recurrence.CONCLUSION: In patients undergoing first-time ablation for AF, both the frequency and later onset of early recurrence are significantly associated with higher odds of late recurrence. This suggests the arbitrary blanking period should be abandoned in favor of a case-by-case assessment when evaluating candidates for re-ablation.

KW - Ablation

KW - Atrial fibrillation

KW - Blanking period

UR - http://www.scopus.com/inward/record.url?scp=85083379845&partnerID=8YFLogxK

U2 - 10.1007/s10840-020-00741-x

DO - 10.1007/s10840-020-00741-x

M3 - Journal article

C2 - 32253599

VL - 60

SP - 271

EP - 278

JO - Journal of Interventional Cardiac Electrophysiology

JF - Journal of Interventional Cardiac Electrophysiology

SN - 1383-875X

IS - 2

ER -

ID: 59663473