Clinical and anatomic predictors of need for repeat atrial fibrillation ablation

Table 1 Clinical predictors of need for repeat ablation n (%)

Parameter	Single ablation (n = 189)	Repeat ablation (n = 142)	P value
Age (yr)	59.2 ± 10.8	57.4 ± 9.5	0.12
Male gender	135 (71)	115 (81)	0.05
Left ventricular ejection fraction	59.8 ± 9.4	57.4 ± 10.3	0.04
Hypertension	114 (61)	79 (57)	0.46
Coronary artery disease	29 (16)	15 (11)	0.22
Diabetes mellitus, type II	13 (7)	13 (9)	0.43
CVA or TIA	3 (2)	1 (1)	0.47
Obstructive sleep apnea	39 (21)	24 (17)	0.42
Congestive heart failure	13 (7)	7 (5)	0.48
Persistent atrial fibrillation	41 (22)	37 (27)	0.31
Medications at initial ablation
Beta blocker	90 (49)	72 (53)	0.45
Calcium channel blocker	28 (15)	24 (18)	0.53
ACE-I or ARB	45 (24)	32 (24)	0.89
Statin	66 (35)	43 (32)	0.47
Warfarin	100 (54)	88 (64)	0.06
Direct OAC	62 (33)	33 (24)	0.07
Anti-arrhythmic drug
Class III
Amiodarone	19 (10)	12 (9)	0.68
Dronedarone	27 (15)	19 (14)	0.89
Sotalol	33 (18)	23 (17)	0.85
Dofetilide	9 (5)	12 (9)	0.15
Class Ic (Flecainide or Propafenone)	54 (29)	41 (30)	0.83
Procedural data
Ablation time (min)	138.3 ± 55.2	148.4 ± 53.5	0.11

Age, left ventricular ejection fraction, and ablation time data presented as mean ± SD. For other clinical parameters, data presented as n (%). Demographic and clinical parameters stratified by patients who received single ablation procedure vs repeat ablation during study period.

Table 2 Anatomic predictors of need for repeat ablation

Pre-ablation size parameters	Single ablation (n = 189)	Repeat ablation (n = 142)	P value
Right atrial area (cm2)1	23.0 ± 5.8	24.4 ± 5.4	0.08
Left atrial area (cm2)1	28.0 ± 5.3	29.3 ± 6.2	0.13
Pulmonary vein ostial diameter (mm)
Right superior vein	19.4 ± 4.0	21.5 ± 4.3	< 0.01
Right inferior vein	18.0 ± 3.5	19.6 ± 5.8	< 0.01
Left superior vein	17.7 ± 3.4	18.7 ± 3.0	< 0.01
Left inferior vein	17.0 ± 2.7	18.6 ± 5.0	< 0.01

Data presented as mean ± SD.

¹Data reported for 123 patients in single ablation group and 81 patients in repeat group. Comparison of cardiac magnetic resonance parameters stratified by patients who received single ablation procedure vs repeat ablation during study period.

Table 3 Multivariate analysis of anatomic and clinical predictors

Variable	Odds ratio (95%CI)	P value
Clinical parameters
Male gender	1.53 (0.77-3.05)	0.23
LVEF	0.98 (0.95-1.01)	0.25
Warfarin	1.04 (0.43-2.51)	0.92
Direct OAC	0.59 (0.24-1.46)	0.25
Anatomic parameters
Right superior PV diameter	1.08 (1.00-1.16)	0.05
Right inferior PV diameter	1.07 (0.99-1.15)	0.09
Left superior PV diameter	1.05 (0.95-1.16)	0.36
Left inferior PV diameter	1.10 (0.99-1.22)	0.07

Multivariate binomial logistic regression of clinical and anatomic variables with univariate P values ≤ 0.1. LVEF: Left ventricle ejection fraction; PV: Pulmonary vein.