Document Detail

Long duration of radiofrequency energy delivery is an independent predictor of clinical recurrence after catheter ablation of atrial fibrillation: over 500 cases experience.
MedLine Citation:
PMID:  22790188     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) is an effective rhythm control strategy, there is a substantial amount of recurrence. We explored the predictors of AF recurrence after RFCA with consistent ablation strategy.
METHODS AND RESULTS: This study included 575 patients (77% male, 56 ± 11 years old) with AF (65.7% paroxysmal AF [PAF], 34.3% persistent AF [PeAF]) who underwent RFCA. We evaluated the clinical, serological, and electrophysiological parameters thereof.
RESULTS: 1. During 15 ± 7 months of follow-up, patients who experienced AF recurrence (21.8%) were older (58 ± 10 vs. 55 ± 11 years old, p=0.019) and more likely to have PeAF (50.4% vs. 29.4%, p<0.001) and greater LA volume (137.3 ± 49.1 vs. 116.6 ± 37.9 mL, p<0.001). 2. In patients with clinical recurrence after RFCA, both ablation time (110.1 ± 43.8 vs. 92.3 ± 30.1 min, p<0.001) and procedure time (222.7 ± 79.6 vs. 205.8 ± 58.8 min, p<0.001) were prolonged, and the early recurrence rate within 3 months of the procedure was higher (63.0% vs. 26.4%, p<0.001) than those without clinical recurrence. 3. In logistic regression analysis, LA volume (OR 1.008, CI 1.001-1.014), ablation time (per quartile, OR 1.380, CI 1.031-1.847), and early recurrence (OR 3.858, CI 2.420-6.150) were independent risk factors for recurrence of AF after RFCA.
CONCLUSION: In this single center consistent study of over 500 cases of AF ablation, patients with AF recurrence had a larger atrium, longer ablation time, and a higher chance of early recurrence than those remained in sinus rhythm. Inadvertent, long duration of ablation was an independent predictor of worse clinical outcomes after catheter ablation of AF.
Jaemin Shim; Boyoung Joung; Jae Hyung Park; Jae-Sun Uhm; Moon-Hyoung Lee; Hui-Nam Pak
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-07-11
Journal Detail:
Title:  International journal of cardiology     Volume:  167     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-09-04     Completed Date:  2014-04-22     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  2667-72     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
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MeSH Terms
Atrial Fibrillation / diagnosis*,  surgery*
Catheter Ablation / methods*
Electrocardiography / methods
Follow-Up Studies
Middle Aged
Predictive Value of Tests
Time Factors
Treatment Outcome

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