Right bundle branch block predicts recurrence after atrial fibrillation ablation in retrospective cohort

This retrospective cohort analysis included 949 patients with atrial fibrillation who underwent de novo radiofrequency catheter ablation (RFCA). The study categorized patients based on the presence of right bundle branch block (RBBB): non-RBBB, incomplete RBBB (IRBBB), or complete RBBB (CRBBB), with the non-RBBB group serving as the comparator. The primary outcome was recurrence after RFCA, with follow-up duration not reported.

Main results showed that the prevalence of CRBBB was 5.3% (n = 50) and IRBBB was 4.4% (n = 42). CRBBB was identified as an independent predictor of recurrence, while IRBBB was not associated with recurrence. Additionally, the prevalence of RBBB increased with aging, with a p-value < 0.05 indicating statistical significance, though exact effect sizes and confidence intervals were not provided.

Safety and tolerability data were not reported. Key limitations include the retrospective design and the need for prospective multicenter investigation to confirm findings. The study used Cox proportional hazards regression models to assess predictive value, but causality cannot be inferred due to the observational nature. In practice, CRBBB may be considered a potential predictor of recurrence in atrial fibrillation patients undergoing RFCA, but clinicians should await further evidence before altering management based on this association.