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01. History of Cardiology
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05. Atrial Fibrillation
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07. Syncope and Bradycardia
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32. Cardiovascular Nursing
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Beyond the Blanking Period: Predictors of Sustained Rhythm Success After Atrial Fibrillation and Atrial Flutter Ablation
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; Maria Leonor Moura; Francisca Martins Nunes; Inês Rodrigues; António Gonçalves; Marta Catarina Almeida; André Lobo; Rafael 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</span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"> Catheter ablation improves rhythm control in atrial fibrillation (AF) and atrial flutter (AFL), yet late recurrence continues to limit long-term success. A range of clinical and structural variables may shape outcomes, but their relative predictive value remains unclear.</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 whether early AF/AFL recurrence (<90 days) predicts late recurrence and to identify additional clinical and structural predictors after catheter ablation.</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 conducted a retrospective cohort study of consecutive patients who underwent AF/AFL ablation between 2017–2021. Baseline demographics, comorbidities, arrhythmia characteristics, atrial measurements and procedural data were collected. Early recurrence was defined as AF/AFL <90 days and late recurrence as ≥90 days. Predictors of late recurrence were assessed using Cox proportional hazards models, including variables with p<0.10 in univariate analysis or considered clinically relevant.</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. The mean age was 58±11 years; 275 (35.9%) were women and 592 (77.2%) had paroxysmal AF. Early AF/AFL recurrence occurred in 94 (12.2%) patients. Over a median follow-up of 25.3 months (IQR 17.3–36.7), late AF/AFL recurrence occurred in 202 (26.3%) patients. In multivariable Cox analysis, early recurrence remained the strongest independent predictor of late recurrence (HR 4.37; 95% CI 3.12–6.12; p<0.001). Female sex was also associated with higher recurrence risk (HR 1.57; 95% CI 1.14–2.16; p=0.006). The number of years since AF diagnosis (HR 1.04 per year; 95% CI 1.00–1.08; p=0.049) and left atrial diameter (HR 1.03 per mm; 95% CI 1.00–1.06; p=0.050) were additional predictors, while age was not significant (p=0.960).</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">Conclusions: Early recurrence during the blanking period is a strong independent predictor of late AF/AFL recurrence. Female sex, longer AF duration and larger left-atrial diameter further contribute to risk stratification, whereas age was not associated with outcomes. These findings reinforce the prognostic value of early post-ablation rhythm status and highlight the need for careful monitoring during the blanking period</span></span></span></p>
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