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Temporal profile of early arrhythmia recurrence and its impact on long-term recurrence after ablation for atrial fibrillation and atrial flutter
Session:
Sessão de Posters 25 - Resultados e recorrência após ablação de FA
Speaker:
Francisco Lemos De Sousa
Congress:
CPC 2026
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.4 Atrial Fibrillation - Treatment
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Francisco Lemos Sousa; Francisca Martins Nunes; Maria Leonor Moura; Inês Rodrigues; António Gonçalves; André Lobo; Marta Catarina Almeida; Rafael Silva Teixeira; Paulo Fonseca; João Almeida; Marco Oliveira; Ricardo Fontes-Carvalho
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Background: Early atrial arrhythmias are common after catheter ablation for atrial fibrillation (AF) and atrial flutter (AFL). While many early recurrences may reflect transient inflammation, others may indicate persistent arrhythmogenic substrates. Whether the timing of early recurrence within the blanking period carries different prognostic significance remains uncertain.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Purpose: To determine how AF/AFL recurrence in the 1st, 2nd, or 3rd month after ablation affects late AF/AFL recurrence.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Methods: We performed a retrospective study of patients undergoing AF/AFL ablation between 2017–2021. Demographics, comorbidities, AF/AFL characteristics, atrial measurements and procedural variables were collected. Early AF/AFL recurrence was categorised into four groups (no recurrence, recurrence in the 1st month, 2nd month or 3rd month post-ablation); recurrence ≥90 days was considered late recurrence. Prediction of late recurrence was assessed using Cox proportional hazards models.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Results: A total of 767 patients were included (mean age 58±11 years); 275 (35.9%) were women and 592 (77.2%) had paroxysmal AF. Early recurrence occurred in 94 (12.2%). During a median follow-up of 25.3 months (IQR 17.3–36.7), 202 patients (26.3%) experienced late recurrence. In multivariable Cox analysis, early recurrence timing showed a graded prognostic impact: recurrence in the 1st month was associated with increased late recurrence risk (HR 4.54; 95% CI 3.15–6.54; p<0.001), as was recurrence in the 2nd month (HR 4.40; 95% CI 2.44–7.96; p<0.001). Recurrence in the 3rd month demonstrated the strongest association (HR 8.91; 95% CI 4.66–17.03; p<0.001). Survival curves showed progressively earlier and steeper divergence from the non-recurrence group across months.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Conclusion: Early AF/AFL recurrence shows timing-dependent prognostic value. Recurrence in the 1st or 2nd month was similarly associated with higher late recurrence risk compared with no early recurrence, while recurrence in the 3rd month showed the strongest association. Timing-based assessment of early recurrence may support refined post-ablation risk stratification and follow-up planning</span></span></span></p>
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