Journal
CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY
Volume 7, Issue 2, Pages 267-273Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/CIRCEP.113.000471
Keywords
atrial fibrillation; catheter ablation; recurrence
Categories
Ask authors/readers for more resources
Background Although catheter ablation (CA) is a standard treatment for atrial fibrillation (AF), its long-term efficacy remains unclear. This study aimed to elucidate the incidences of AF recurrence and of progression from paroxysmal to persistent AF, after CA, in patients with paroxysmal AF. Methods and Results We examined the incidence of AF recurrence and AF progression in 1220 consecutive patients (mean age, 61 years), with symptomatic paroxysmal AF, undergoing CA, based on extensive pulmonary vein isolation and focal ablation for nonpulmonary vein foci. AF recurrence-free survival probabilities at 5 years were 59.4% after the initial CA and 81.1% after the final CA (average, 1.3 procedures). During a median follow-up period of 47.9 (range, 5.3-123.3) months after the initial CA, AF progressed from paroxysmal to persistent in 15 (1.2%) patients (0.3%/y). The duration of AF history (hazard ratio [HR], 1.03; P<0.0001), number of ineffective antiarrhythmics (HR, 1.09; P=0.005), and left atrial diameter indexed by the body surface area (HR, 1.05; P=0.001) were significant predictors of AF recurrence. Patient age (HR, 1.12; P=0.0001) and left atrial diameter indexed by the body surface area (HR, 1.26; P=0.0006) were significantly associated with AF progression. Patients aged 65 years and with a left atrial diameter indexed by the body surface area of 24.0 mm/m(2) did not develop AF progression for 10 years after the initial CA. Conclusions Although the long-term follow-up revealed the effect of CA on preventing AF recurrence, repeated CA sessions might be required. The rate of progression from paroxysmal to persistent AF was 0.3%/y.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available