Can Complex Fractionated Atrial Electrogram Recur at the Same Site in Patients with Redo Catheter Ablation of Atrial Fibrillation?

We questioned whether Complex Fractionated Atrial Electrogram (CFAE) can recur at the same site as in first ablation and relate to outcome of the patients underwent redo catheter ablation (re-CA) of atrial fibrillation (AF). METHODS Out of 173 patients undergoing re-CA of AF, 7 patients (3.4%, 60± 12 years) in whom automated CFAE (NavX map) guided ablation was performed at the first and re-CA were studied. RESULTS Mean time interval to re-CA was 21± 11 months. In 4 of 7 patients (57.1%), no PV reconnection was observed at re-CA. In 6 of 7 patients, LA septum and anterior wall near the LA appendage (LAA) were the most common recurrence sites of CFAE. In 3 patients, AF terminated during ablation of recurrent CFAEs. The CFAE CL became longer (62.5± 10.7ms vs. 88.9± 30.7ms, P=0.06) and % of area of CFAE smaller (3.0± 1.3% vs. 0.8± 0.9%, P=0.003) than in those at the first ablation. There were no significant differences in LA diameter and LA volume (46.1± 8.8mm vs 41.9± 8.9mm, P=NS, 144± 57.6 cm3 vs 121± 47.2 cm3, P=NS) between two procedures. CONCLUSIONS In re-CA, areas of CFAE became smaller and CFAE CL longer than in those at first ablation. The CFAEs at the septum and peri-LAA were frequently recurred, in which AF terminated during re-CA in 43%.