Hybrid Atrial Fibrillation Ablation: Association of Clinical Characteristics, Biomarkers, and Blanking Period with Recurrence.

0 CARDIAC & CARDIOVASCULAR SYSTEMS

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2025-09-01 DOI:10.1093/icvts/ivaf197

Marieke J H Velt, Federico T Magni, Yuri Blaauw, Massimo A Mariani, Theo J Klinkenberg, Michiel Rienstra, Bart A Mulder

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Abstract

Objectives: Hybrid atrial fibrillation (AF) ablation is a treatment for therapy-resistant, symptomatic AF. Limited data exist on the risk factors for failure of the procedure. Therefore, this study aimed to identify clinical factors and blood biomarkers associated with atrial arrhythmia recurrence within 2 years following hybrid ablation.

Methods: The hybrid AF ablation study is a single-centre, prospective, observational study including consecutive AF patients who underwent hybrid ablation between January 2015 and September 2021. Blood samples were collected pre-ablation, and 7 biomarkers were assessed based on their possible association with recurrence. The blanking period was defined as the first 3 months after ablation. Clinical follow-up visits combined with 12-lead electrocardiogram (ECG) and 72-hour Holter monitoring were scheduled at 3, 6, 12, and 24 months post-procedure. Cox proportional hazard regression analyses were performed to assess the association with recurrence.

Results: Of the 91 patients included (mean age 57.1 years [standard deviation: 8.1]; 16% women), 31 (34%) experienced atrial arrhythmia recurrence within 2 years following hybrid ablation, with a median time to recurrence of 254 days (interquartile range 147-428). Multivariable Cox proportional hazard regression, adjusted for age and sex, showed that recurrence in the blanking period was associated with atrial arrhythmia recurrence within 2 years post-ablation (hazard ratio 4.05, 95% confidence interval 1.85-8.91); however, no association was detected between other clinical factors or blood biomarkers and atrial arrhythmia recurrence.

Conclusions: In AF patients undergoing hybrid ablation, recurrence in the blanking period was associated with atrial arrhythmia recurrence within 2 years post-ablation.

Clinical registration: ClinicalTrials.gov, NCT02516033, https://clinicaltrials.gov/ct2/show/NCT02516033.

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混杂房颤消融：临床特征、生物标志物和空白期与复发的关系。

目的：混合型房颤（AF）消融是治疗难治性症状房颤的一种治疗方法。有关该手术失败的危险因素的数据有限。因此，本研究旨在确定与混合消融后两年内心房心律失常复发相关的临床因素和血液生物标志物。方法：混合式房颤消融研究是一项单中心、前瞻性、观察性研究，包括2015年1月至2021年9月期间接受混合式房颤消融的连续房颤患者。消融前采集血液样本，并评估7种生物标志物与复发的可能关联。空白期定义为消融后的前3个月。术后3、6、12和24个月进行12导联心电图和72小时动态心电图监测的临床随访。采用Cox比例风险回归分析来评估与复发的关系。结果：纳入的91例患者(平均年龄57.1岁（标准差8.1）；16%的女性)，31例（34%）在混合消融术后两年内复发心房心律失常，复发的中位时间为254天（四分位数范围147-428）。经年龄和性别校正的多变量Cox比例风险回归显示，消融术后2年内房性心律失常复发与消融术后空白期复发相关（风险比4.05,95%可信区间1.85-8.91）；然而，其他临床因素或血液生物标志物与心房心律失常复发之间未发现关联。结论：房颤混合消融患者，消融期复发与消融后2年内房性心律失常复发相关。

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Interdisciplinary cardiovascular and thoracic surgery

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