Predictors of Recurrence After Atrial Fibrillation Ablation

doi:N/A

Bangaldesh Journal of Cardivascular Medicine

2025, Volume 3, Issue 1 : 1-4

Research Article

Predictors of Recurrence After Atrial Fibrillation Ablation

Michael R. Anderson

Sarah L. Thompson

Ahmed K. Rahman

Emily J. Foster

⁴

Department of Cardiac Electrophysiology, Global Heart Institute, Boston, USA

Division of Cardiovascular Medicine, University Medical Center, London, UK

Department of Electrophysiology, National Heart Centre, Dubai, UAE

⁴

Department of Clinical Research, International Cardiovascular Sciences Institute, Sydney, Australia

Abstract

Background: Catheter ablation is an established rhythm-control strategy for atrial fibrillation, but recurrence remains common, especially in persistent AF and patients with advanced atrial remodeling.

Objective: To identify clinical, echocardiographic, biochemical, and procedural predictors of AF recurrence after catheter ablation.

Methods: A prospective observational study included 720 patients undergoing first-time AF ablation between January 2020 and December 2024. Patients were followed for 24 months. Recurrence was defined as documented AF, atrial flutter, or atrial tachycardia lasting ≥30 seconds after a 3-month blanking period.

Results: AF recurrence occurred in 24.6% of patients at 12 months and 31.8% at 24 months. Independent predictors included persistent AF, left atrial diameter >45 mm, obesity, diabetes mellitus, sleep apnea, longer AF duration, elevated NT-proBNP, incomplete pulmonary vein isolation, and early recurrence during the blanking period.

Conclusion: AF recurrence after ablation is multifactorial. Careful patient selection, risk-factor modification, complete pulmonary vein isolation, and structured follow-up may improve long-term ablation success.

Keywords

Atrial fibrillation

Catheter ablation

Recurrence

Predictors

Pulmonary vein isolation

Atrial remodeling

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