Persistent atrial fibrillation and risk factors for recurrence at 3 and 12 months after interventional therapy

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Abstract

Background: This study examined the early recurrence (within the first 3 months) of atrial fibrillation (AF) in patients with persistent AF, focusing on the effective refractory period (ERP) of the left atrium and pulmonary veins and clinical and laboratory comorbidities. Furthermore, the study evaluated outcomes 12 months after treatment.

Materials and methods: Sixty patients with persistent AF refractory to antiarrhythmic therapy were included. Each patient underwent ERP assessment of the left atrium and pulmonary veins, followed by radiofrequency antral isolation of the pulmonary vein ostia. The patients were grouped into two based on ERP values: group 1, patients with average ERP values of the left atrium and pulmonary veins ≥ 240 ms and group 2, those with average ERP values < 240 ms. The incidence of early AF recurrence was assessed within the first 3 months based on ERP values, and the efficacy of catheter ablation was evaluated at 12 months.

Results: No significant differences were found in instrumental parameters (echocardiography and multislice computed tomography), laboratory findings (serum creatinine and glomerular filtration rate), and comorbidities between patients with and without early AF recurrence. However, the risk of early AF recurrence in group 2 was 6 times higher compared to that in group 1 (p = 0.04), and the risk of recurrence within 12 months after catheter ablation was 4 times higher (p = 0.02).

Conclusions: These findings indicate that an ERP of the left atrium and pulmonary veins below 240 ms may predict early AF recurrence (p = 0.04), AF recurrence within 12 months (p = 0.03), and the need for repeated ablation (p = 0.02). Clinical and laboratory comorbidities were not found to be significant predictors of early AF recurrence following interventional therapy in patients with persistent AF.

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About the authors

Alimzhan T. Kozhenov

Municipal Clinical Hospital No. 15 named after O.M. Filatov

Author for correspondence.
Email: alim_kozhenov@outlook.com
ORCID iD: 0009-0005-1750-1586
SPIN-code: 9593-9519

cardiovascular surgeon

Russian Federation, Moscow

Sardor N. Azizov

Federal Center for Cardiovascular Surgery named after S.G. Sukhanov

Email: azizov.s89@mail.ru
ORCID iD: 0009-0006-1678-9175
SPIN-code: 4867-6630

MD, Cand. Sci. (Medicine)

Russian Federation, Perm

Olga V. Khlynova

Academician Ye.A. Vagner Perm State Medical University

Email: olgakhlynova@mail.ru
ORCID iD: 0000-0003-4860-0112
SPIN-code: 2713-9138

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Perm

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2. Fig. 1. Overall survival curve in the study groups

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3. Fig. 1. Overall survival curve in the study groups

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