Primary endpoint
At one-year, 71 patients had experienced AF/AT recurrences after one or more procedures, with no difference between the groups: 43/135 HF patients relapsed (31.9%) versus 28/111 control patients (25.2%), p=0.262. The average rate of repeated ablation was 17.1% with a trend toward a greater number of procedures performed in the HF group (1.2±0.5 procedures vs 1.1±0.4 respectively, p=0.065). Nevertheless, there was also no difference in recurrence rates between HF and non-HF groups after the index procedure (44.4% vs 36% respectively, p=0.196). In multivariate analysis using Cox regression, the cumulative risk of AF/AT recurrence was significantly higher in case of mitral regurgitation (Hazard ratio [HR]=2.38, 95% confidence interval [CI] 1.22 to 4.69, p=0.011), hypertrophic cardiomyopathy (HR= 2.35, 95% CI 1.21 to 4.57, p=0.011) and persistent AF (HR=1.89, 95% CI 1.11 to 3.22, p=0.02). AF/AT recurrence rates were not significantly different, considering the type of ablation catheter used (36% with contact force catheter versus 47% with other catheter, p=0.277). About a quarter of the patients (62/246) had interrupted their antiarrhythmic drug therapy at one-year regardless of HF status. One-year survival without AF/AT recurrence was not modified by antiarrhythmic drug regimen, in both groups. Survival curves are represented by the Kaplan Meier method in Figure 2. Primary and secondary outcomes are detailed in Table 2.