Objective: This study sought to explore the impact of metabolic syndrome (MS) on the risk of recurrence after catheter ablation of long-standing persistent atrial fibrillation (AF).
Methods: Totally 248 patients [197 male, (56±12)years] with persistent AF and catheter ablation were included. Long-standing persistent AF was defined based on the duration (more than one year).
Results: Among the 248 patients, 96 (38.7%) patients had MS, 130 (52.4%) patients had long-standing persistent AF. After 91-1222 (404±303) days follow-up, 119 (47.9%) had recurrence. The recurrence rate was significantly higher in the MS group than that in the non-MS group (58.3% vs 41.4%, P = 0.017). The proportion of MS was similar between the long-standing persistent AF group and the non-long-standing persistent AF group (36.9% vs 40.7%, P = 0.544). Subjects with MS had higher recurrence rate than those without MS in non-long-standing AF group (56.3% vs 32.9%, P = 0.033), but not in long-standing AF group (60.4% vs 48.8%, P = 0.177). In multivariate analysis, MS (hazard ratio 1.98, 95% CI 1.04-3.76, P = 0.036) and AF history duration (hazard ratio 1.04, 95% CI 1.01-1.07, P = 0.004) were independent risk factors for recurrence after catheter ablation of AF. Long-standing persistent AF was not an independent risk factor of recurrence.
Conclusion: MS was natively associated with the success rate of catheter ablation of AF in patients with non-long-standing persistent AF, but not in patients with long-standing persistent AF.