Impact of body mass index on the outcome of catheter ablation of atrial fibrillation

ObjectivesThe association between obesity and atrial fibrillation (AF) is well-established. We aimed to evaluate the impact of index body mass index (BMI) on AF recurrence at 12 months following catheter ablation using propensity-weighted analysis. In addition, periprocedural complications and fluoroscopy details were examined to assess overall safety in relationship to increasing BMI ranges.MethodsBaseline, periprocedural and follow-up data were collected on consecutive patients scheduled for AF ablation. There were no specific exclusion criteria. Patients were categorised according to baseline BMI in order to assess the outcomes for each category.ResultsAmong 3333 patients, 728 (21.8%) were classified as normal (BMI <25.0 kg/m2), 1537 (46.1%) as overweight (BMI 25.5–29.0 kg/m2) and 1068 (32.0%) as obese (BMI ≥30.0 kg/m2). Procedural duration and radiation dose were higher for overweight and obese patients compared with those with a normal BMI (p=0.002 and p<0.001, respectively). An index BMI ≥30 kg/m2 led to a 1.2-fold increased likelihood of experiencing recurrent AF at 12-months follow-up as compared with overweight patients (HR 1.223; 95% CI 1.047 to 1.429; p=0.011), while no significant correlation was found between overweight and normal BMI groups (HR 0.954; 95% CI 0.798 to 1.140; p=0.605) and obese versus normal BMI (HR 1.16; 95% CI 0.965 to 1.412; p=0.112).ConclusionsPatients with a baseline BMI ≥30 kg/m2 have a higher recurrence rate of AF following catheter ablation and therefore lifestyle modification to target obesity preprocedure should be considered in these patients.

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Impact of body mass index on outcomes in European patients with atrial fibrillation: the ESC EHRA EORP Atrial Fibrillation General Long-Term registry (AFGen LT)

European Heart Journal ◽

10.1093/ehjci/ehaa946.3022 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

G Boriani ◽

M Proietti ◽

C Laroche ◽

L Fauchier ◽

F Marin ◽

...

Keyword(s):

Atrial Fibrillation ◽

Body Mass Index ◽

Body Mass ◽

Large Cohort ◽

Funding Source ◽

Increased Risk ◽

Underweight Patients ◽

The Impact

Abstract Introduction The impact of body mass index (BMI) on outcomes in patients with atrial fibrillation (AF) has been largely debated. Aims To describe the relationship between BMI categories and clinical outcomes in a large cohort of European AF patients. Methods We included all AF patients with available baseline BMI and creatinine clearance and 1-year follow-up data enrolled in the EORP-AF General Long-Term Registry. Outcomes considered were: i) a composite of any thromboembolic event (TE)/acute coronary syndrome (ACS)/cardiovascular (CV) death; ii) CV death; iii) all-cause death. Results A total of 7,759 patients were included in this analysis. Of these, 55 (0.7%) were underweight, 2,074 (26.7%) were normal weight, 3,170 (40.9%) were overweight, 1,703 (21.9%) were obese and 757 (9.8%) were severe obese. Mean age was progressively lower across the categories (p<0.0001), with proportion of patients aged≥75 years also progressively lower (52.7% in underweight to 19.4% in severe obese patients; p<0.001). Both underweight (41.8%) and severe obese (25.0%) patients were more likely symptomatic (p<0.001). Mean CHA2DS2-VASc score was higher in underweight patients (p=0.0325). Use of any oral anticoagulant therapy was progressively higher across the BMI categories (p<0.001). At 1-year follow-up the rate of all outcomes considered were highest for underweight patients and lowest in severe obese [Figure 1]. On univariate Cox regression analysis, being underweight was consistently associated to a higher risk for all outcomes, while increasing of weight categories was associated with progressively lower risk for adverse outcomes. After full adjustment with clinical and pharmacological characteristics, no effect of higher BMI classes was found for any outcome, but an independent association with an increased risk of CV death and all-cause death was seen for underweight patients (Table 1). Conclusions In a large cohort of European AF patients a progressively lower rate of outcomes was found across increasing BMI classes. After full adjustments, no significant association was found between the higher BMI classes and outcomes. Underweight was associated with an increased risk for CV death and all-cause death. Figure 1. Outcomes at 1-year Follow-up Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Since the start of EORP programme, several companies have supported it with unrestricted grants

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P985The long-term impact of maintaining sinus rhythm on the risk for death or heart failure after catheter ablation for atrial fibrillation in a real world clinical practice

European Heart Journal ◽

10.1093/eurheartj/ehz747.0578 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

T Yoshizawa ◽

H Shiomi ◽

M Tanaka ◽

T Aizawa ◽

S Yamagami ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Catheter Ablation ◽

P Value ◽

Af Ablation ◽

Risk Of Death ◽

The Impact ◽

Af Recurrence

Abstract Background Catheter ablation has been rapidly spread as a first line therapy for atrial fibrillation (AF). A recent randomized trial have shown that AF ablation reduces the risk of death or hospitalization for heart failure (HF). However, the impact of maintained sinus rhythm (SR) on long-term risk of death or HF hospitalization has not been adequately evaluated. Purpose To investigate the impact of maintaining SR by AF ablation on long-term risk of all-cause death or HF hospitalization. Methods The long-term clinical outcomes were compared between patients with maintained SR and those with recurrent AF using a landmark analysis in which the landmark point was set at 1.5-year after the 1st ablation. Results Among consecutive 1467 patients who underwent AF ablation in our institution between February 2004 and December 2017, the study population consisted of 1311 patients after excluding 150 patients because of death or lost to follow-up. Mean age was 67.9±0.3 and paroxysmal AF was 67%. Among 460 patients who had AF recurrence within 1.5 years after the 1st ablation, 328 underwent 2nd ablation. Therefore, at 1.5-year after the 1st AF ablation, 1145 patients had maintained SR rhythm (SR-group), and 166 patients had recurrent AF episodes (AF-group). During 4.7±2.4 years of follow-up, the cumulative 5-year incidence of death or HF beyond 1.5 years after the 1st ablation was 5.1% in SR-group and 15.6% in AF-group (log rank P<0.001). After adjusting for baseline confounders, the lower risk of SR-group relative to AF-group for death or HF was still statistically significant (HR: 2.05, 95% CI: 1.11–3.58, P=0.02). Risks for a Composite of Death or HF Hazard Ratio (95% CI) Crude HR P value Adjusted HR P value AF recurrence 2.59 (1.43–4.43) 0.002 2.05 (1.11–3.58) 0.02 Age>75 years old 2.55 (1.56–4.10) <0.001 2.32 (1.39–3.81) 0.002 Female 0.85 (0.49–1.43) 0.56 0.73 (0.40–1.25) 0.26 PeAF 1.25 (0.68–2.16) 0.45 0.98 (0.52–1.75) 0.94 LSAF 1.10 (0.46–2.23) 0.82 0.70 (0.28–1.53) 0.39 LVEF>50% 0.27 (0.16–0.48) <0.001 0.57 (0.31–1.09) 0.09 Past history of HF 7.06 (4.18–11.6) <0.001 4.67 (2.51–8.41) <0.001 CKD 4.74 (2.08–9.39) <0.001 2.23 (0.94–4.69) 0.07 AF, Atrial fibrillation; PeAF, Persistent AF; LSAF; Long standing AF; HF, Heart failure; CKD, Chronic kidney disease. Figure 1 Conclusions Successfully maintained SR was associated with reduced long-term risk for death or HF hospitalization in real world patients undergoing AF ablation.

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Impact of body mass index on atrial fibrillation ablation using cryoballoon: procedural data and clinical outcomes

European Heart Journal ◽

10.1093/ehjci/ehaa946.0420 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

L Urbanek ◽

S Chen ◽

S Bordignon ◽

N Tsianakas ◽

F Bologna ◽

...

Keyword(s):

Atrial Fibrillation ◽

Body Mass Index ◽

Pulmonary Vein ◽

Body Mass ◽

Pulmonary Vein Isolation ◽

Clinical Success ◽

Cryoballoon Ablation ◽

Group 3 ◽

The Impact

Abstract Background The impact of body mass index (BMI) on atrial fibrillation (AF) ablation using cryoballoon (CB) has been seldom reported. Purpose To evaluate the impact of BMI on procedural data as well as the clinical efficacy and safety character of using CB. Methods Symptomatic AF patients (paroxysmal / persistent AF) with BMI ≥25 who underwent CB based pulmonary vein isolation (PVI) were enrolled. CB PVI was performed using the second generation CB (CB 2, 28mm), with 4min based freeze protocol and bonus freeze delivery in case of time-to-isolation (TTI) >75 sec. All procedures were performed under conscious sedation. Procedural endpoint was electrical pulmonary vein isolation. Clinical success was defined as no recurrence of AF/atrial tachycardia (AT). Results Data from 600 consecutive patients were collected. Three groups defined: BMI 25–29 (Group 1, G1 n=337); BMI 30–34 (Group 2, G2 n=149); BMI ≥35 (Group 3, G3 n=114). Patients in Group 3 were younger (G1: 67±11 y; G2: 68±10y G3 62±11y; p<0,001) and presented bigger LA (G1 39,5±4,9 mm; G2: 41,6±5,5; G3 42,4±5,1; p<0,001). Most of the patients presented with PAF (G1: 59,3% G2: 57,7% G3: 54,4%). Among 2342 Targeted PVs, 2332 (99,6%) were isolated using solely the CB (G2: one procedure was abolished due to failed aortic puncture during transseptal access; G3: one PVI was not completed due to PNP; 6 touch up RF ablation in G1 and 2 in G3). Procedure time (G1:58,45 min; G2: 60,44 min; G3 63,19 min) and fluoroscopy time (G1: 9,3 min; G2: 9,5 G3: 10,6 min) were comparable among the groups. PN Injury was the main recorded complication: 20/600 (2,6%) patients with a transient PN palsy (PNP) and 6/600 (1%) with a persistent PNP. No sedation related complication was recorded. Follow up survival curve analysis after one year revealed a favorable follow up in G1 (78,4%) and G2 (82,5%) compared to G3 (66,5%) (G1 Vs G3 p: 0,002 G2 vs G3 p=0,008, G1 vs G2 p=0,47). The influence of BMI on the follow up was confirmed in the subgroup of patients with paroxysmal AF but not in patients presenting persistent AF. Conclusions Cryoballoon ablation in obese patients is feasible and associated with a relatively low complication rate. BMI plays a role in predicting recurrences especially in patients presenting with paroxysmal AF. Funding Acknowledgement Type of funding source: None

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The impact of body mass index on the efficacy and safety of catheter ablation of atrial fibrillation

International Journal of Cardiology ◽

10.1016/j.ijcard.2011.06.092 ◽

2013 ◽

Vol 164 (1) ◽

pp. 94-98 ◽

Cited By ~ 39

Author(s):

Konstantinos P. Letsas ◽

Claudia Herrera Siklódy ◽

Panagiotis Korantzopoulos ◽

Reinhold Weber ◽

Gerd Bürkle ◽

...

Keyword(s):

Atrial Fibrillation ◽

Body Mass Index ◽

Catheter Ablation ◽

Body Mass ◽

Efficacy And Safety ◽

The Impact

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Nonalcoholic fatty liver disease and the risk of atrial fibrillation stratified by body mass index: a nationwide population-based study

Scientific Reports ◽

10.1038/s41598-021-83367-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

So-Ryoung Lee ◽

Kyung-Do Han ◽

Eue-Keun Choi ◽

Seil Oh ◽

Gregory Y. H. Lip

Keyword(s):

Atrial Fibrillation ◽

Body Mass Index ◽

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Body Mass ◽

Fatty Liver Disease ◽

Nonalcoholic Fatty Liver ◽

Increased Risk ◽

The Impact

AbstractWe evaluated the association between nonalcoholic fatty liver disease (NAFLD) and incident atrial fibrillation (AF) and analyzed the impact of NAFLD on AF risk in relation to body mass index (BMI). A total of 8,048,055 subjects without significant liver disease who were available fatty liver index (FLI) values were included. Subjects were categorized into 3 groups based on FLI: < 30, 30 to < 60, and ≥ 60. During a median 8-year of follow-up, 534,442 subjects were newly diagnosed as AF (8.27 per 1000 person-years). Higher FLI was associated with an increased risk of AF (hazard ratio [HR] 1.053, 95% confidence interval [CI] 1.046–1.060 in 30 ≤ FLI < 60, and HR 1.115, 95% CI 1.106–1.125 in FLI ≥ 60). In underweight subjects (BMI < 18.5 kg/m2), higher FLI raised the risk of AF (by 1.6-fold in 30 ≤ FLI < 60 and by twofold in FLI ≥ 60). In normal- and overweight subjects, higher FLI was associated with an increased risk of AF, but the HRs were attenuated. In obese subjects, higher FLI was not associated with higher risk of AF. NAFLD as assessed by FLI was independently associated with an increased risk of AF in nonobese subjects with BMI < 25 kg/m2. The impact of NAFLD on AF risk was accentuated in lean subjects with underweight.

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Abstract 15380: Association of Change in Body Mass Index With Premature Atrial Contractions Frequency and Atrial Fibrillation in Older Age: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽

10.1161/circ.142.suppl_3.15380 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Joseph Decker ◽

Wendy Wang ◽

Faye L Norby ◽

Romil Parikh ◽

Jorge L Reyes ◽

...

Keyword(s):

Atrial Fibrillation ◽

Body Mass Index ◽

Body Mass ◽

The Elderly ◽

Atherosclerosis Risk In Communities ◽

Aging Adults ◽

Aric Study ◽

Multivariable Adjustment ◽

Adjustment Table

Introduction: The proportions of obese and aging adults are rapidly growing. While obesity and advancing age are associated with atrial fibrillation (AF), data are limited on weight change in the elderly as a risk factor for premature atrial contractions (PACs)—which are known to precede AF—or AF. Hypothesis: Compared to a stable body mass index (BMI) over time, increasing BMI will be associated with a higher PAC frequency and AF in elderly participants in ARIC. Methods: We included N=2,070 ARIC participants [age mean ± SD 79 ± 4.5 years, 59% female] without known AF who attended visit 6 and wore an ambulatory ECG-monitoring device (Zio XT® Patch, iRhythm Technologies Inc.) for ≥48 hours. BMI change was defined as change between V5 (2011-13) and V6 (2016-17) and was categorized into 4 groups: >10% decrease, 2 to 10% decrease, -2 to 2% change (stable BMI) and > 2% increase. PAC frequency was defined as percent of beats that are PACs. Linear regression was used to evaluate the association between BMI change and % PAC. Incident AF was ascertained after V6 through 2018 from hospital discharge codes and death certificates. Logistic regression was used to evaluate the association between BMI change and incident AF. Results: Median PACs per hour were 8.84. Participants with >2% BMI increase had 0.35% (95% CI: 0.06%-0.64%) higher frequency of PACs compared to those with stable BMI after multivariable adjustment (Table). After a mean (SD) follow-up of 19 (7) months, there were 82 incident AF cases. Compared to stable BMI, both >2% BMI increase and 2 to 10% decrease were nonsignificantly associated with higher odds of AF compared with stable BMI after multivariable adjustment (Table). Conclusion: Increasing BMI in the elderly is associated with higher PAC frequency and is nonsignificantly associated with higher odds of AF compared to stable BMI. This finding suggests that weight management, which is currently emphasized in middle age, may also apply in late-life to prevent atrial arrhythmias.

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Body Mass Index and Its Change from Adolescence to Adulthood Are Closely Related to the Risk of Adult Metabolic Syndrome in China

International Journal of Endocrinology ◽

10.1155/2021/8888862 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Bingyang Liu ◽

Yue Li ◽

Jiamei Guo ◽

Yuting Fan ◽

Ling Li ◽

...

Keyword(s):

Metabolic Syndrome ◽

Body Mass Index ◽

Body Mass ◽

Glycosylated Hemoglobin ◽

Early Adulthood ◽

Study Groups ◽

Relationship Of ◽

Baseline Bmi ◽

The Relationship

Aims. To investigate the influence of body mass index (BMI) and its change from adolescence to adulthood (ΔBMI) on the risk of metabolic syndrome (MetS) in early adulthood. Methods. We selected 931 students from 12 to 16 years of age in Liaoyang City, China. Ninety-three participants from 18 to 22 years of age with complete baseline data were available for follow-up after 5 years. Statistical analysis determined the relationship of MetS at follow-up with baseline BMI (BMIb), ΔBMI, and follow-up BMI (BMIf). Results. ΔBMI was positively correlated with the change of waist circumference (ΔWC), systolic blood pressure (ΔSBP), triglycerides (ΔTG), uric acid, and glycosylated hemoglobin (ΔHbA1c) in follow-up ( p < 0.05 ). For every 1 kg/m2 increase in BMIb, ΔBMI, and BMIf, the risk of MetS at follow-up increased 1.201-fold, 1.406-fold, and 1.579-fold, respectively. Both BMIb and ΔBMI were predictive of MetS at follow-up, with prediction thresholds of 23.47 kg/m2 and 1.95 kg/m2. The participants were divided by the predicted BMIb and ΔBMI threshold values into four study groups. Interestingly, the group with lower BMI but a higher increase in BMI presented the same metabolic derangements and Mets% of the group with higher BMI but lower Δ BMI. Conclusion. Both BMI of adolescence and ΔBMI were predictive of MetS and cardiovascular risk factors in adulthood. Control of both variables in adolescents would be more effective in decreasing the risk of MetS in young adults than control of BMI alone.

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Physical activity modifies the risk of atrial fibrillation in obese individuals: The HUNT3 study

European Journal of Preventive Cardiology ◽

10.1177/2047487318784365 ◽

2018 ◽

Vol 25 (15) ◽

pp. 1646-1652 ◽

Cited By ~ 14

Author(s):

Lars E Garnvik ◽

Vegard Malmo ◽

Imre Janszky ◽

Ulrik Wisløff ◽

Jan P Loennechen ◽

...

Keyword(s):

Physical Activity ◽

Atrial Fibrillation ◽

Body Mass Index ◽

Confidence Interval ◽

Body Mass ◽

High Body Mass Index ◽

Overweight And Obesity ◽

Hazard Ratio ◽

Increased Risk

Background Atrial fibrillation is the most common heart rhythm disorder, and high body mass index is a well-established risk factor for atrial fibrillation. The objective of this study was to examine the associations of physical activity and body mass index and risk of atrial fibrillation, and the modifying role of physical activity on the association between body mass index and atrial fibrillation. Design The design was a prospective cohort study. Methods This study followed 43,602 men and women from the HUNT3 study in 2006–2008 until first atrial fibrillation diagnosis or end of follow-up in 2015. Atrial fibrillation diagnoses were collected from hospital registers and validated by medical doctors. Cox proportional hazard regression analysis was performed to assess the association between physical activity, body mass index and atrial fibrillation. Results During a mean follow-up of 8.1 years (352,770 person-years), 1459 cases of atrial fibrillation were detected (4.1 events per 1000 person-years). Increasing levels of physical activity were associated with gradually lower risk of atrial fibrillation ( p trend 0.069). Overweight and obesity were associated with an 18% (hazard ratio 1.18, 95% confidence interval 1.03–1.35) and 59% (hazard ratio 1.59, 95% confidence interval 1.37–1.84) increased risk of atrial fibrillation, respectively. High levels of physical activity attenuated some of the higher atrial fibrillation risk in obese individuals (hazard ratio 1.53, 95% confidence interval 1.03–2.28 in active and 1.96, 95% confidence interval 1.44–2.67 in inactive) compared to normal weight active individuals. Conclusion Overweight and obesity were associated with increased risk of atrial fibrillation. Physical activity offsets some, but not all, atrial fibrillation risk associated with obesity.

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Abstract 13246: The Impact of Body-Mass Index Trajectories During Early Adulthood on Cardiac Mechanics in Middle Age: The CARDIA Study

Circulation ◽

10.1161/circ.130.suppl_2.13246 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Sadiya S Khan ◽

Sanjiv J Shah ◽

Kiang J Liu ◽

Cora E Lewis ◽

Christina Shay ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Young Adulthood ◽

Cardiac Dysfunction ◽

Middle Age ◽

Cardiac Mechanics ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

The Impact ◽

Baseline Bmi

Introduction: Obesity is a risk factor for left ventricular dysfunction and incident heart failure. We hypothesized that baseline body mass index (BMI) and trajectories in weight change through young adulthood are associated with abnormal cardiac mechanics in middle age. Methods: We examined 2,735 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study. BMI was calculated at exam years 0, 2, 5, 7, 10, 15, 20, 25. 2D echo was performed with speckle-tracking analysis. Left ventricular ejection fraction (LVEF) and global longitudinal, circumferential, and radial strain (GLS, GCS, GRS, respectively) were measured at y25. Group-based modeling with latent class analysis (PROC TRAJ) was used to identify trajectories in relative changes in BMI (% change in BMI from baseline at each exam). Linear regression examined associations between baseline BMI and trajectory of BMI change and absolute GLS, GCS, and GRS at y25 adjusting for demographics, risk factors, and echo parameters. Results: Mean age at baseline was 25±4 years. Baseline BMI at y0 was significantly associated with mean GLS at y25 (p=0.01), but not GRS or GCS. We identified 4 distinct trajectories of relative BMI change: stable weight (36% of sample), mild increase (40%), moderate increase (18%), and major increase (6%) in weight (Figure). At y25, there was no difference in LVEF across the 4 BMI trajectory groups (P=NS). After adjustment for clinical variables and baseline BMI, absolute GLS was lower in groups with BMI increases (overall P<0.001). GRS and GCS were not significantly different between the groups. Conclusion: In conclusion, baseline BMI and increases in BMI during young adulthood are significantly associated with the presence of subclinical cardiac dysfunction in middle age despite normal EF. This novel characterization of BMI trajectories across young adulthood may assist in improving understanding of the impact of weight gain and obesity on cardiac dysfunction.

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Abstract 5659: Regular Atrial Tachycardias After Ablation Of Complex Fractionated Atrial Electrograms (CFAE) For Atrial Fibrillation: Acute Incidence And Recurrence In Clinical Follow-up

Circulation ◽

10.1161/circ.118.suppl_18.s_979 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Tilko Reents ◽

Gabriele Hessling ◽

Stephanie Fichtner ◽

Jinjin Wu ◽

Heidi L Estner ◽

...

Keyword(s):

Atrial Fibrillation ◽

Catheter Ablation ◽

Successful Ablation ◽

Atrial Electrograms ◽

Initial Procedure ◽

The Impact ◽

External Cardioversion ◽

Complex Fractionated Atrial Electrograms

Background: The catheter ablation of atrial fibrillation (AF) can be performed by ablation of complex fractionated atrial electrograms (CFAE). Endpoint of CFAE ablation is the regularisation or termination of AF. However, the impact of regular atrial tachycardia (AT) occurring during CFAE ablation on long term outcome has not been investigated. Thus, it is not clear whether these tachycardias should be acutely targeted for ablation. Methods: In 43 patients (31 male, age 62±9 years with paroxysmal (15 patients), persistent (25 patietns) or permanent AF (3 patients) organisation of AF to regular AT was achieved by ablation of CFAE. Mapping of AT with subsequent successful ablation was performed in 14/43 patients (33%), in the remaining 29/43 patients (67%) AT was terminated with external cardioversion or pace overdrive. After ablation procedure, patients were seen in our out-patient clinic with repetitive Holter ECG after 1, 3, and subsequently every 3 months and were intensively screened for the occurrence of regular AT. Results: In follow-up 22/43 patients (51%) developed sustained AT necessitating in 20 patients repeat catheter ablation (12 patients) or external cardioversion (8 patients). AF had been paroxysmal in 7/22 and persisten in 15/22 patients with AT in follow-up. In 14/22 patients (63%), no attempt for ablation of AT had been made during the initial procedure, in 8/22 AT (36%) had been mapped and initially successful ablated. Of 21 patients without AT occurrence during follow-up, AF had been paroxysmal in 8/21 and persistent or permanent in 13/21 patients. AT had been mapped and ablated in 6 (29%) whereas in 15/21 patients (71%), AT had not been targeted. Ablation of AT during initial procedure, number of ablation applications, procedure and fluoroscopy duration were not predictive for freedom of AT in follow-up. Conclusion: In our study, mapping and successful ablation of new onset regular atrial tachycardias (AT) occurring during ablation of CFAE for atrial fibrillation was not predictive for the occurrence of AT in follow-up. Thus, results after termination of AT by cardioversion was in long-term comparable to sometimes time-consuming mapping/ablation for AT.

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