Temporal trends in atrial fibrillation recurrence rates after ablation between 2005 and 2014: a nationwide Danish cohort study

Aims During the last decade, ablation has increasingly been used in rhythm control management of patients with atrial fibrillation (AF). Over time, experience and techniques have improved and indications for ablation have expanded. The purpose of this study was to investigate whether the recurrence rate of AF following ablation has improved during last decade. Methods and results Through Danish nationwide registers, all patients with first-time AF ablation, between 2005 and 2014 in Denmark were identified. Recurrent AF after ablation was identified with 1 year follow-up. A total of 5425 patients undergoing first-time ablation were included. While patient median age increased over time the median AF duration prior to ablation decreased. The rates of recurrent AF decreased from 45% in 2005-2006 to 31% 2013-2014 with the relative risk of recurrent AF almost halved with an odds ratio of 0.57 [95% confidence intervals (95% CI) 0.47-0.68] in 2013-2014 compared with patients undergoing ablation in 2005-2006. Female gender, hypertension, AF duration >2 years, and cardioversion within 1 year prior to ablation were all associated with an increased risk of recurrent AF. Conclusion One year risk of recurrent AF following first-time ablation has almost halved from 2006 to 2014. Hypertension, female sex, cardioversion 1 year prior to ablation, and AF duration for more than 2 years all increased the associated risk of recurrent AF.

[1]  P. Kirchhof,et al.  2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. , 2016, European heart journal.

[2]  J Hartikainen,et al.  Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation: results on health-related quality of life and symptom burden. The MANTRA-PAF trial. , 2015, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[3]  Prashanthan Sanders,et al.  Long‐term Outcomes of Catheter Ablation of Atrial Fibrillation: A Systematic Review and Meta‐analysis , 2013, Journal of the American Heart Association.

[4]  J. Olesen,et al.  Temporal changes in patient characteristics and prior pharmacotherapy in patients undergoing radiofrequency ablation of atrial fibrillation: a Danish nationwide cohort study. , 2013, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[5]  C. Blomström-Lundqvist,et al.  Atrial fibrillation ablation techniques. , 2012, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[6]  Huai Sheng Chen,et al.  Catheter ablation for paroxysmal and persistent atrial fibrillation. , 2012, The Cochrane database of systematic reviews.

[7]  José Jalife,et al.  2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation , 2012, Heart rhythm.

[8]  Daniel Steven,et al.  Long-term single- and multiple-procedure outcome and predictors of success after catheter ablation for persistent atrial fibrillation. , 2011, Heart rhythm.

[9]  R. Winkle,et al.  Long-term results of atrial fibrillation ablation: the importance of all initial ablation failures undergoing a repeat ablation. , 2011, American heart journal.

[10]  David O. Martin,et al.  Natural History and Long-Term Outcomes of Ablated Atrial Fibrillation , 2011, Circulation. Arrhythmia and electrophysiology.

[11]  S. Matsuo,et al.  Dormant pulmonary vein conduction induced by adenosine in patients with atrial fibrillation who underwent catheter ablation. , 2011, American heart journal.

[12]  Ethan M Balk,et al.  Predictors of Atrial Fibrillation Recurrence After Radiofrequency Catheter Ablation: A Systematic Review , 2010, Cardiovascular Electrophysiology.

[13]  D. Lin,et al.  Long-Term Outcome After Successful Catheter Ablation of Atrial Fibrillation , 2010, Circulation. Arrhythmia and electrophysiology.

[14]  R. Hunter,et al.  Long-term efficacy of catheter ablation for atrial fibrillation: impact of additional targeting of fractionated electrograms , 2010, Heart.

[15]  Elia Biganzoli,et al.  Updated Worldwide Survey on the Methods, Efficacy, and Safety of Catheter Ablation for Human Atrial Fibrillation , 2005, Circulation. Arrhythmia and electrophysiology.

[16]  David O. Martin,et al.  Impact of type of atrial fibrillation and repeat catheter ablation on long-term freedom from atrial fibrillation: results from a multicenter study. , 2009, Heart rhythm.

[17]  S. Themistoclakis,et al.  Clinical predictors and relationship between early and late atrial tachyarrhythmias after pulmonary vein antrum isolation. , 2008, Heart rhythm.

[18]  A. Russo,et al.  Characteristics of Patients Undergoing Atrial Fibrillation Ablation: Trends Over a Seven‐Year Period 1999–2005 , 2007, Journal of cardiovascular electrophysiology.

[19]  C. Tai,et al.  Predictors of non-pulmonary vein ectopic beats initiating paroxysmal atrial fibrillation: implication for catheter ablation. , 2005, Journal of the American College of Cardiology.

[20]  Douglas Packer,et al.  Worldwide Survey on the Methods, Efficacy, and Safety of Catheter Ablation for Human Atrial Fibrillation , 2005, Circulation.

[21]  J Clémenty,et al.  Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. , 1998, The New England journal of medicine.

[22]  Wolters Kluwer,et al.  Hrs/ehra/ecas Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design: a Report of the Heart Rhythm Society (hrs) Task Force , 2022 .