Jinsun Park, Myung-Jin Cha, Chang Hee Kwon, Min Soo Cho, Gi-Byoung Nam, Il-Young Oh, So-Ryoung Lee, Ju Youn Kim, Sung Ho Lee, Junbeom Park, Ki-Hun Kim, Pil-Sung Yang, Jun Hyung Kim, Jaemin Shim, Hong Euy Lim
Predictors of ERAT and LRAT differed between patients with paroxysmal and those with persistent AF. LA enlargement was the most consistently shared predictor across recurrence phenotypes.
INTRODUCTION: Patient characteristics and predictors of early (ERAT) and late (LRAT) recurrence of atrial tachyarrhythmia by atrial fibrillation (AF) type after cryoballoon ablation (CBA) remain poorly defined.
METHODS: Using the Korean Heart Rhythm Cryoballoon Registry (12 centers, 2018-2022), 2051 patients undergoing CBA for drug-refractory AF were stratified by AF type. ERAT was defined as atrial tachyarrhythmia within the 3-month blanking period and LRAT as recurrence beyond 3 months. Independent predictors of ERAT (all patients) and LRAT (patients without ERAT) were identified.
RESULTS: ERAT occurred in 631 patients (30.8%; 17.6% in paroxysmal and 40.4% in persistent AF). Among 1420 patients without ERAT, LRAT occurred in 311 (21.9%; 16.7% paroxysmal, 27.2% persistent). In paroxysmal AF, coronary artery disease (HR 1.60; 95% CI, 1.00-2.56; p = 0.048) and LA enlargement (HR 1.07; 95% CI, 1.04-1.10; p < 0.001) predicted ERAT, whereas hypertrophic cardiomyopathy (HR 5.01; 95% CI, 2.20-11.42; p < 0.001) and LA enlargement (HR 1.04; 95% CI, 1.01-1.08; p = 0.019) predicted LRAT. In persistent AF, AF duration (HR 1.04; 95% CI, 1.02-1.06; p < 0.001) and LA enlargement (HR 1.03; 95% CI, 1.02-1.04; p < 0.001) predicted ERAT, and LA enlargement (HR 1.03; 95% CI, 1.01-1.05; p = 0.010) independently predicted LRAT.
CONCLUSION: Predictors of ERAT and LRAT differed between patients with paroxysmal and those with persistent AF. LA enlargement was the most consistently shared predictor across recurrence phenotypes.