Predictive factors for recurrent paroxysmal atrial fibrillation after catheter ablation
Keywords:
atrial fibrillation; catheter ablation; echocardiography; electrocardiography; risk factors; systematic reviewAbstract
Introduction: Paroxysmal atrial fibrillation is an arrhythmia with high recurrence rate after catheter ablation. The identification of predictive factors is essential for risk stratification and guiding follow-up strategies aimed at reducing functional impairment and potential associated complications.
Objective: To identify predictive factors for recurrent paroxysmal atrial fibrillation after catheter ablation.
Methods: A systematic review was conducted on PubMed, Cochrane, LILACS, and SciELO databases (2014–2024). Boolean operators were used in the search strategy. Original studies in English, Portuguese, and Spanish involving adult patients after catheter ablation, and which identified clinical, electrocardiographic, and echocardiographic predictors of recurrence were included. Preprints and studies not involving human participants were excluded. Of the 313 records identified, 9 were included.
Results: A total of 4,219 patients that suffer from paroxysmal atrial fibrillation were involved. Recurrences were reported in 1,403 patients (33.25 %). Relevant clinical predictors included hemodialysis treatment, head-up tilt test positive, alcohol consumption and resting heart rate < 50 beats/min. Electrocardiographic predictors included low voltage index and interatrial advanced block. Relevant echocardiographic predictors included left atrial diameter and functional mitral regurgitation.
Conclusions: Recurrence of paroxysmal atrial fibrillation after catheter ablation is associated with a multifactorial risk profile, and predictive factors related to electrical conduction and chamber growth predominate.
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References
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