AF recurrence and other factors
AADs after RFCA were a strong confounding factor for an AF recurrence.
In our study, the LA size in the patients with an output of
> 5 J was larger than that in those with an output of ≤ 5
J. However, the IDF threshold remained as an independent predictor of an
AF recurrence. These findings suggested that a greater AF substrate
remained in the patients with an output > 5 J after the
RFCA. On the other hand, there was no significant difference in the
presence of non-PV foci between the patients with an output of ≤ 5 J and
those with an output > 5 J. In addition, the LA size was
not associated with AF recurrence, however, the LA size was larger in
the patients with an output of > 5 J. Those findings
suggested that not only eliminating AF triggers but also approaching the
LA substrate were important, because those patients with an output of
> 5 J had a higher rate of AF recurrence and greater AF
substrate. Recent studies have demonstrated that the efficacy of
substrate ablation is questionable.23, 24 In our
study, AADs after the RFCA could not prevent AF recurrence especially in
patients with an output of > 5 J. Therefore, further
studies are need to study those patients with an output of
> 5 J.