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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:  Publisher    
Abstract/OtherAbstract:
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±11years 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±7months of follow-up, patients who experienced AF recurrence (21.8%) were older (58±10 vs. 55±11years 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±37.9mL, p<0.001). 2. In patients with clinical recurrence after RFCA, both ablation time (110.1±43.8 vs. 92.3±30.1min, p<0.001) and procedure time (222.7±79.6 vs. 205.8±58.8min, p<0.001) were prolonged, and the early recurrence rate within 3months 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.
Authors:
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     Date:  2012-7-10
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
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