Predictors of atrial fibrillation recurrence after pulmonary vein isolation

Introduction: It is well known that pulmonary vein isolation (PVI) could be curative in paroxysmal atrial fibrillation (PAF). It is not well known what are the clinical factors involved in AF recurrence aft er PVI. Methods: We included 78 consecutive patients (pt) 57.41 ± 8.05 years, 66.7% men. Circumferential or segmental PVI was performed by radiofrequency in 58 patients (74.4%), and by cryoablation in 18 patients (23.1%). Antral PVI was obtained at 35 W and minus 40°. We assessed the following parameters as possible predictors of AF recurrence at 6 months after procedure: men (M), less than 24 hours of PAF (PAF1), less than 7 days (PAF7), arrhythmia duration (AFD), obesity, sleep apnea syndrome defi ned as apnea-hypopnea index AHI ≥ 10, anterior-posterior diameter (LAD), indexed left atrial volume assessed by echocardiography (linear – LAV1 and biplane – LAV2 formula), computer-tomography (LAV3) and left ventricular ejection fraction (LVEF) <50%. Results: 53 pt 67.9% (Group I) had no recurrence of AF and 25 pt (32%) (Group II) had AF recurrence after PVI. AF recurrence aft er PVI wasn’t predictable by compared univariate analysis Group I vs Group II: M 39 (73.6%) pt vs. 4 (40.0%) pt, FAP1 41 (77.4%) pt vs. 8 (80.0%) pt, FAP7 12 pt (22.6%) vs 2 pt (20.0%), AFD 5.24 ± 4.2 ani vs. 16.83 ± 5.35 ani, IMC ≥ 30 20 pt (37.7%) vs 4 pt (40.0%), AHI ≥ 10 31 pt (59.6%) vs 6 (60.0%), LAD 40.79 ± 6.14 mm vs 37.89 ± 12.64 mm, LAV1 23.70 ± 10.64 ml vs 26.74 ± 14.65 ml, LAV2 43.62 ± 18.52 ml vs. 42.54 ± 9.41 ml, FEVS < 50% 5 pt (9.4%) vs 0 pt. Men gender, AF history, obesity and sleep apnea were identified by multivariate logistic regression analysis as clinical predictors of PAF recurrence after PVI (P 0.025), 69.0% of sensibility and 69.8% of specificity.
Conclusions: Men gender, AF duration, obesity and sleep apnea syndrome are clinical predictors of PAF recurrence aft er pulmonary vein isolation only by multivariate analysis, but there are not single predictors for recurrences.

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