부산대학교 도서관

Introduction: Following catheter ablation (CA) for atrial fibrillation (AF), early recurrence (ER) during the 3 month blanking period (BP) may be significant for late recurrence (LR). Recognition of LR during BP has clinical value.Purpose: We investigated whether relapses of AF shortly after cardioversion for ER were associated with LR.Methods and Results: 1405 consecutive first-time CAs for AF were performed at our institution from March 2012 to March 2016. 359 patients underwent cardioversion (PAF; n=165, non PAF; n=194) in the ER. Two response groups were identified. 1. an acute-relapse group (relapses of atrial tachyarrhythmia within 10 minutes of BP after restoration of sinus rhythm (SR) by cardioversion electrically or pharmacologically; n=150 (41.8%)) and 2. a non-relapse group (who maintained SR after cardioversion for beyond the 10 minutes of BP, n=209 (58.2%)). We compared the incidence of LR between each group. ER and LR were defined as recurrent atrial tachyarrhythmia lasting for >30 seconds during the BP and after the BP. At the median follow-up period of 566 days after CA, 80.7% of patients in the acute-relapse group experienced LR compared to 38.8% of patients in the non-relapse group. The incidence of LR was significantly higher in the acute-relapse group than in the non-relapse group (hazard ratio [HR]; 3.17, 95% confidence interval [CI]; 2.36-4.26, p<0.001). Relapse of AF shortly after cardioversion was a significant predictor of LR even after adjustment for age, sex, type of AF, left atrial diameter and history of congestive heart failure in the multivariate model (HR; 4.00, 95% CI; 2.60-6.15, p<0.001).Conclusions: Following catheter ablation for atrial fibrillation, acute-relapses after cardioversion during blanking period were frequent and were strongly associated with late recurrences.