Abstract
BACKGROUND: The prevalence of right bundle branch block (RBBB) among patients with atrial fibrillation (AF) and its prognostic value after radiofrequency catheter ablation (RFCA) remain unclear. This study aimed to investigate the prevalence of complete RBBB (CRBBB) and incomplete RBBB (IRBBB) and to evaluate their impact on recurrence after RFCA in patients with AF. METHODS: A total of 949 consecutive AF patients who underwent de novo RFCA between 2018 and 2020 were retrospectively analyzed. Patients were categorized into non-RBBB, IRBBB, and CRBBB groups. Baseline clinical characteristics were compared among groups. Kaplan-Meier analysis and Cox proportional hazards regression models were used to assess the predictive value of RBBB for recurrence. RESULTS: The prevalence of CRBBB and IRBBB among AF patients was 5.3% (n = 50) and 4.4% (n = 42), respectively, and both increased with aging (p < 0.001). During a median follow-up of 790 days (interquartile range: 495-1086 days), the recurrence rates in the non-RBBB, IRBBB, and CRBBB groups were 32.2%, 23.8%, and 56.0%, respectively. Log-rank analysis revealed significant differences in sinus rhythm maintenance among the three groups (χ(2) = 10.357, p = 0.006). After adjustment for confounding factors, multivariate Cox regression analysis demonstrated that CRBBB was an independent predictor of recurrence after RFCA (HR = 1.83; 95% CI: 1.04-3.23; p = 0.037), whereas IRBBB was not significantly associated with recurrence. CONCLUSION: The prevalence of RBBB is relatively high among AF patients undergoing RFCA and increases with aging. CRBBB may be an independent predictor of recurrence, whereas IRBBB is not associated with recurrence. The results should be proved by prospective multicenter investigation in the future.