Recurrence Pattern of Atrial Tachyarrhythmia after Radiofrequency Catheter Ablation of Atrial Fibrillation and Its Responsiveness to Anti-Arrhythmic Drugs

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Background: Whether anti-arrhythmic drug (AAD) responsiveness is improved after radiofrequency catheter ablation (RFCA) of AF is not clear. Methods: We reviewed the recurrence pattern and responsiveness to AAD of atrial tachycardia (AT)/fibrillation (AF) in 398 patients (307 men, mean age 56.0±10.9, 122 Persistent (Pe) AF who underwent radiofrequency catheter ablation (RFCA) of AF. Results: During 11.2±4.5 months follow-up, 130 (32.7%) patients recurred within 3 month (ER) and 84 (21.1%) patients recurred after 3 month (LR) of RFCA. 74.5% of ER remained in sinus rhythm (SR) with AAD, and slower heart rate at ER (Exp(B) 0.977; CI 0.961∼0.992, p=0.004) and later timing of ER (Exp(B) 1.017; CI 1.002∼1.031, p=0.021) after RFCA were independent predictors for LR. We used IC AAD (36.7%) or amiodarone (AMD; 46.9%). SR restoration rate were 70.1% in class IC and 64.5% in AMD (p=0.664) within 15.2±34.3 days. PeAF (Exp(B) 5.924, CI 1.292∼27.153, p=0.022) and LR (Exp(B) 9.042, CI 2.017∼40.527, p=0.004) were independent predictor of failed SR conversion with AMD. The proportions of AT in recurred ECG were 31.5% in ER and 37.3% in LR, and AAD responsiveness of AT (65.0%) was not different to AF (69.0%, p=0.612). Conclusion: Slower heart rate at ER and later ER were predictors for LR. Overall AAD responsiveness was 67.6% after RFCA of AF, but the patients with LR and PeAF were predictors for poor responsiveness to AMD.