SPC365

Evaluating the value of the timing of recurrence during blanking period after atrial fibrillation ablation

Session: Posters (Sessão 1 - Écran 2) - Arritmias 1 - Fibrilhação Auricular 1
Speaker: Gonçalo José Lopes Da Cunha

Congress: CPC 2022
Topic: C. Arrhythmias and Device Therapy
Theme: 05. Atrial Fibrillation
Subtheme: 05.4 Atrial Fibrillation - Treatment
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Gonçalo Lopes da Cunha; Gabriela Bem; Anaí Durazzo; Daneil Matos; Gustavo Rodrigues; João Carmo; Maria Salomé Carvalho; Pedro Galvão Santos; Francisco Moscoso Costa; Pedro Carmo; Diogo Cavaco; Francisco Morgado; Miguel Mendes; Pedro Adragão

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Arial&quot;,sans-serif">Introduction</span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Arial&quot;,sans-serif">In the first weeks after atrial fibrillation (AF) ablation, the arrythmia may recur theoretically due to <span style="background-color:white"><span style="color:black">transient local inflammation and not due to treatment failure. This is defined as the blanking period, with a proposed duration of 3 months. Recently, this time period has been brought into question. The aim of this work was to evaluate the correlation between the timing of blanking recurrence and late AF recurrence.</span></span></span></span></span></p>

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<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="background-color:white"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black">Methods</span></span></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="background-color:white"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black">This was a single-centre retrospective study including patients without structural heart disease that underwent first AF ablation and were subsequently enrolled in the post ablation structured program between 2018 and 2021. Patients were excluded if they had &lt;6months follow-up. Appointment with ECG and Holter monitoring was performed at 1, 3, 6 and 12 months after ablation.</span></span></span></span></span></p>

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<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="background-color:white"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black">Results</span></span></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="background-color:white"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black">We included a total of 193 patients (56% male, mean age </span></span></span><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black">63&plusmn;12 years). Of these, 79% had paroxysmal AF and mean left atrial volume index was 58&plusmn;18mL/m2</span></span><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black">. During the 3-month blanking period, there were 39 (21%) recurrences, 18 (9%) of which in the first month. After blanking period, at 6 months, 25 (13%) patients had AF recurrence, 56% of which had already recurred during blanking period. AF recurrence in the 2<sup>nd</sup> and 3<sup>rd</sup> month of blanking increased the odd of recurrence at 6-month by more than 5-fold (odds ratio (OR) 8,944; CI 95% 2,817-28,400 p&lt;0.001 and OR 5,591; 95% CI 1,173-26,651; p=0.031). On the other hand, recurrence of AF during the 1<sup>st</sup> month of blanking was not associated with increased chance of 6-month AF recurrence (OR 2,095, 95% CI 0,630-6,964, p=0.227) (</span></span><strong><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:#5b9bd5">figure 1</span></span></strong><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black">). There were no significant differences in clinical variables, including LA volume, between patients with 1-month recurrence and patients without recurrences. However, patients with AF recurrence in the 2<sup>nd</sup> and 3<sup>rd</sup> month of blanking had significantly increased LA volume.</span></span></span></span></p>

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<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black">Conclusion</span></span></span></span></p>

<p><span style="font-size:11.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black">Our study suggests that patients with AF recurrence in the 2<sup>nd</sup> and 3<sup>rd</sup> month of blanking have structurally different atria and are at a significantly higher risk of post blanking AF recurrence, in contrast with patients with AF recurrence in the 1<sup>st</sup> month of blanking, thus questioning the appropriate duration of the blanking period.</span></span></span></p>