Document Detail


Incidence and predictors of very late recurrence of atrial fibrillation after ablation.
MedLine Citation:
PMID:  17081214     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Radiofrequency catheter ablation can effectively treat patients with refractory atrial fibrillation (AF). Very late AF recurrence (> or = 12 months post-ablation) is uncommon and may represent a unique patient cohort. METHODS AND RESULTS: A nested case-control study was performed in the cohort who underwent AF ablation at the University of Pennsylvania to characterize patients who develop very late AF recurrence after ablation. The procedure consisted of isolation of pulmonary veins (PVs) demonstrating triggers and elimination of non-PV triggers initiating AF. Twenty-seven (7.9%) patients with very late recurrence were compared to 219 patients without recurrence and > or = 12 months of follow-up. The mean age was 54.6 +/- 11.3 years and 79% were men. Very late recurrence patients more likely weighed >200 lbs (70% vs 55%, P = 0.01); during initial ablation had fewer PVs isolated (2.8 +/- 1.1 vs 3.3 +/- 1.0, P = 0.03); and were less likely to have right inferior PV isolation (37% vs 61%, P = 0.02), less likely to have isolation of all PVs (30% vs 56%, P = 0.01), and more likely to have non-PV triggers (30% vs 11% OR 3.4(95% CI, 1.3-8.7), P = 0.01). PV reconnectivity and new triggers were found in the majority of patients with very late recurrence of AF who underwent repeat ablation. CONCLUSION: Very late recurrence of AF more likely occurred in patients >200 lbs who demonstrated non-PV triggers and did not undergo right inferior PV isolation. The majority of patients undergoing repeat ablation for very late recurrence demonstrated PV reconnectivity and new non-PV and PV triggers not observed during the initial ablation.
Authors:
Sumeet K Mainigi; William H Sauer; Joshua M Cooper; Sanjay Dixit; Edward P Gerstenfeld; David J Callans; Andrea M Russo; Ralph J Verdino; David Lin; Erica S Zado; Francis E Marchlinski
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Publication Detail:
Type:  Journal Article     Date:  2006-11-01
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  18     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-18     Completed Date:  2007-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  69-74     Citation Subset:  IM    
Affiliation:
Electrophysiology Section, Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Atrial Fibrillation / diagnosis,  epidemiology*,  surgery
Catheter Ablation*
Echocardiography, Transesophageal
Electrophysiologic Techniques, Cardiac
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Pennsylvania / epidemiology
Postoperative Period
Prognosis
Recurrence
Reoperation
Retrospective Studies
Time Factors
Comments/Corrections
Comment In:
J Cardiovasc Electrophysiol. 2007 Jan;18(1):75-6   [PMID:  17229303 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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