Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO03 - Poster Session III (ID 48) Poster

D-PO03-178 - Post-ablation High Sinus Heart Rate Is Associated With A Lower Clinical Recurrence In Persistent Atrial Fibrillation (ID 1141)


Background: Although atrial fibrillation (AF) catheter ablation increases sinus heart rate (SHR), its mechanism has not yet been clearly elucidated.
Objective: We hypothesize that post-AF ablation higher SHR is associated with a better clinical outcome of AF ablation.
Methods: Subjects were consecutive 132 patients with persistent AF (male: 75%, age: 63.3±8.6) who underwent radio frequency catheter ablation from Apr. 2015 to Dec. 2016. We evaluated the recurrence rate and results of 24-hour Holter monitoring at 3 months after catheter ablation.
Results: Thirty-seven patients (28.0%) had AF recurrence in the follow-up period (median735 days). Holter monitoring was performed at 98.5 day in median value. Total SHR was clearly high in patients with free from AF (106440 vs 98998, p=0.045). Total SHR was divided into three groups: HIGH-group; more than 11000 beats per day, MIDDLE-group; from 11000 to 10000, and LOW-group; less than 10000. Using the Kaplan-Meier estimator, the recurrence free rate was clearly difference in the three groups (p=0.016). Considering the recurrence rate of HIGH-group and MIDDLE-group, the rate did not change until one year later. But the recurrence rate gradually increased in MIDDLE-group after that. HIGH-group achieved low recurrence rate at 1000 day, while LOW-group has a clearly higher recurrence rate than HIGH-group (0.89 vs 0.47, p<0.01).
Conclusion: Post-ablation high SHR was associated with a significantly lower clinical recurrence. It might be affected by responsiveness of ganglionated plexi and potential of sick sinus syndrome. This result might affect the frequency of examination at follow-up and the continuation of anticoagulant therapy.