Abstract
Termination of Atrial Fibrillation During Catheter Ablation Predicts Better Outcome. Background: The reliable endpoint for ablation of longstanding persistent atrial fibrillation (LPAF) has not been clearly established. Methods and Results: This study included 140 patients who underwent catheter ablation for drug-refractory LPAF. A stepwise ablation approach included circumferential pulmonary vein isolation followed by left atrial and right atrial complex fractionated electrogram-guided ablation. Atrial fibrillation (AF) was terminated by radiofrequency application during catheter ablation in 95 patients (67.9%). Among them, 33 patients (23.6%) converted to sinus rhythm directly, whereas 62 patients (44.3%) via atrial tachycardias (ATs). Patients in whom AF terminated during the index procedure had a lower recurrence rate of atrial arrhythmia than patients in whom AF did not terminate (45.3% vs 68.9%, P = 0.009, follow-up 18.7 ± 7.6 months). Among patients in whom AF terminated, there was no significant difference in recurrence rate according to the termination mode, whether converted to AT or not (P = NS). However, patients who converted to AT had a higher recurrence rate of AT (54.8% vs 81%; P = 0.016). Multivariable logistic regression analysis demonstrated that termination of AF during ablation (HR 0.440; 95% CI: 0.200-0.969, P = 0.041) and structural heart disease (HR 2.633; 95% CI: 1.211-5.723; P = 0.015) were significant independent factors predicting the recurrence of atrial arrhythmia. Conclusions: Termination of AF during catheter ablation is associated with a better clinical outcome in patients with LPAF.
Original language | English |
---|---|
Pages (from-to) | 1051-1058 |
Number of pages | 8 |
Journal | Journal of Cardiovascular Electrophysiology |
Volume | 23 |
Issue number | 10 |
DOIs | |
Publication status | Published - 2012 Oct |
Keywords
- atrial tachycardia
- catheter ablation
- complex fractionated atrial electrograms
- left atrial flutter
- persistent atrial fibrillation
- pulmonary vein isolation
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)