Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia.
School of Medicine, University of Belgrade, Belgrade, Serbia.
Sci Rep. 2018 Jun 29;8(1):9875. doi: 10.1038/s41598-018-28072-y.
Early recurrence of atrial fibrillation (ERAF) after catheter-ablation (CA) can be a transient phenomenon due to inflammation, or a harbinger of late AF recurrence due to CA lesion (re)conduction. We studied the relationship between ERAF and the 3-month CA lesions integrity. Forty one consecutive AF patients who underwent a pulmonary vein isolation (PVI), roof line (RL) and mitral isthmus line (MIL) CA were enrolled. At 3 months all patients underwent invasive assessment of the lesion set integrity irrespective of ERAF. The PVI, RL and MIL ablation was successful in 100.0%, 95.1% and 82.9% patients, respectively. At the 3-month remapping, a gap in PVI-lesion(s), RL or MIL was identified in 61.0%, 31.7% and 36.6% patients, respectively. Patients with (n = 17, 41.5%) compared to those without ERAF (n = 24) had a significantly higher rate of any PV-reconnection (88.2% vs. 41.7%), the right PV(s)-reconnection (82.5% vs. 29.2%) and the RL gap (52.9% vs. 16.7%), as well as a higher number of reconnected right PVI-segments, all p < 0.05. On multivariate analysis, only the number of reconnected right PVI-segments was associated with ERAF (OR 4.26, p = 0.004). The ERAF following PVI + RL + MIL ablation was significantly related to 3-month PV-reconnections and the presence of RL gaps.
房颤导管消融后早期复发（ERAF）可能是炎症引起的短暂现象，也可能是由于消融所致的 CA 病变（再）传导导致晚期 AF 复发的先兆。我们研究了 ERAF 与 3 个月 CA 病变完整性之间的关系。连续纳入 41 例接受肺静脉隔离（PVI）、房顶线（RL）和二尖瓣峡部线（MIL）CA 的房颤患者。所有患者在 3 个月时均接受了侵入性评估，无论 ERAF 如何，均评估了病变集的完整性。PVI、RL 和 MIL 消融在 100.0%、95.1%和 82.9%的患者中获得成功。在 3 个月的重新映射中，在 61.0%、31.7%和 36.6%的患者中分别发现 PVI 病变、RL 或 MIL 存在间隙。与无 ERAF 患者（n=24）相比，有 ERAF 患者（n=17）的任何 PV 再连接（88.2% vs. 41.7%）、右 PV（s）再连接（82.5% vs. 29.2%）和 RL 间隙（52.9% vs. 16.7%）的发生率显著更高，所有 p 值均<0.05。多变量分析显示，只有右 PVI 再连接的节段数与 ERAF 相关（OR 4.26，p=0.004）。PVI+RL+MIL 消融后 ERAF 与 3 个月时的 PV 再连接和 RL 间隙的存在显著相关。
