Procedural Parameters in Predicting Late Recurrence Following Catheter Ablation of Paroxysmal Atrial Fibrillation

<b>Background</b>: To investigate the predictive value of catheter ablation parameters during pulmonary vein isolation (PVI) on long-term recurrence in patients with paroxysmal atrial fibrillation (pAF). <b>Methods</b>: A retrospective analysis was conducted on 386 pAF patients who underwent initial catheter-based radiofrequency ablation (RFA) for PVI. After excluding ineligible cases and those lost to follow-up, 150 patients were included (mean follow-up: 28.86 ± 3.03 months). Patients were divided into recurrence and AF-free groups. Ablation parameters including catheter contact force (CF), ablation index (AI), and GAPs were collected via the CARTO VISITAG Module, and Cox regression was used to identify recurrence predictors. <b>Results</b>: The 2-year AF recurrence rate was 13.33% (20/150). No significant differences in baseline clinical characteristics, AI compliance rate, VISITAG GAP incidence, ablation points and time, or complication rates were observed between groups (<i>p</i> > 0.05). However, CF compliance rate was significantly lower in the AF recurrence group compared to AF-free group (79.17% vs. 90.10%, <i>p</i> < 0.001), and it was an independent predictor of late AF recurrence (HR = 0.950, 95%CI: 0.919-0.981; <i>p</i> = 0.002). <b>Conclusion</b>: CF compliance rate is independently associated with late AF recurrence after PVI. Maintaining stable CF during ablation may promote durable lesions and potentially reduce recurrence risk.