Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-129 - Predictive Factors Of Arrhythmia-recurrence After Multiple Procedures Of Radiofrequency Catheter Ablation For Paroxysmal Atrial Fibrillation: Insight From Kansai Plus Atrial Fibrillation Registry (ID 454)


Background: The predictors of recurrent atrial tachyarrhythmias (RAT) after radiofrequency catheter ablation(CA) for paroxysmal atrial fibrillation(PAF) have not yet been fully evaluated.
Objective: The aim of this study was to develop and validate a risk scoring system to predict RAT after the final CA for PAF.
Methods: The study population consisted of 3223 consecutive patients undergoing first-time CA for PAF from Nov. 2011 to Mar. 2014 in 26 cardiovascular centers in Japan who were enrolled in the Kansai Plus Atrial Fibrillation(KPAF) registry. We developed a scoring system in a derivation cohort(DC) with 2149 patients and assessed its reproducibility in a validation cohort (VD) with 1074 patients. The primary endpoint was RAT lasting for => 30 seconds after 91 days post the final ablation.
Results: During a median follow-up period of 3.1 years, 404(18.8%) patients of the DC had RAT after the final CA. There was no significant difference in the baseline characteristics between DC and VC. The results of the multivariate logistic regression models identified 5 independent variables of RAT: female (odds ratio (OR)=1.5, p<0.01), body mass index (BMI)<25 kg/m2 (OR=1.4, p<0.01), duration of AF history 3years<= (OR=1.4, p<0.01), chronic kidney disease(CKD) (stage 2/3: OR=2.1, p<0.01, stage4/5: OR=2.6, p<0.02), and left ventricular ejection fraction (LVEF) (EF <50%: OR=2.1, p<0.04 , EF 50<=-<60%: OR=1.5, p<0.03 ). The predictive score for each factor was 3 points for CKD stage 4/5, 2 for CKD stage2/3 and EF <50%, and 1 for the others (11 points in total). Figure 1 shows RAT-free rates in DC and VC.
Conclusion: Our newly developed scoring system could reproducibly predict RAT after the final CA for PAF.