Delayed recurrence of atrial fibrillation 2 years after catheter ablation is associated with metabolic syndrome

Background Whether delayed clinical recurrence of atrial fibrillation (AF) 2 years after radiofrequency catheter ablation (CR_> 2-years) is related to AF progression remains unclear. Objective We hypothesized that metabolic factors are associated with CL_> 2-years. Methods Among 1825 patients who underwent catheter ablation, the study included 523 patients with AF recurrence (27.2% women, mean age 57 ± 11 years, 58.3% paroxysmal AF) 3 months after the ablation procedure. They were divided into the clinical recurrence within 2-years (CL_≤ 2-years: AF recurrence at 3–24 months) and CL_> 2-years (AF recurrence > 24 months) groups. Clinical and imaging parameters and polysomnograms were compared. Results Over 42 ± 19 months of follow-up, 409 (78.2%) and 114 (21.8%) patients formed the CL_≤ 2-years and CL_> 2-years groups, respectively. The CL_> 2-years group had higher proportions of overweight (p = 0.004), hypertension (p = 0.049), diabetes mellitus (p = 0.037), dyslipidemia (p = 0.009), high sensitivity C-reactive protein > 8 mg/L (p = 0.049), and metabolic syndrome (p = 0.011) than the CL_≤ 2-years group. Despite no significant difference between the apnea and hypopnea indices in the CL_≤ 2-years (n = 97) and CL_> 2-years (n = 28) groups, the minimum peripheral oxygen saturation was significantly lower in the latter than the former (p = 0.032). In the multivariate analysis, overweight (odds ratio [OR] 1.756, 95% confidence interval [CI] 1.146–2.693, p = 0.010), dyslipidemia (OR 1.587, 95% CI 1.033–2.438, p = 0.035), and metabolic syndrome (OR 1.972, 95% CI 1.158–3.356, p = 0.012) were independently associated with CL_> 2-years. Conclusions Overweight, dyslipidemia, and metabolic syndrome are independent predictors of CL_> 2-years for AF after catheter ablation. CL_> 2-years seems to be affected by metabolic factors and can be related to AF progression.