Document Detail


Natural history and long-term outcomes of ablated atrial fibrillation.
MedLine Citation:
PMID:  21493959     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Atrial fibrillation (AF) ablation is increasingly used in clinical practice. We aimed to study the natural history and long-term outcomes of ablated AF.
METHODS AND RESULTS: We followed 831 patients after pulmonary vein isolation (PVI) performed in 2005. We documented clinical outcomes using our prospective AF registry with most recent update on this group of patients in October 2009. In the first year after ablation, 23.8% had early recurrence. Over long-term follow-up (55 months), only 8.9% had late arrhythmia recurrence defined as occurring beyond the first year after ablation. Repeat ablations in patients with late recurrence revealed conduction recovery in at least 1 of the previously isolated PVs in all of them and right-sided triggers with isoproterenol testing in 55.6%. At last follow-up, clinical improvement was 89.9% (79.4% arrhythmia-free off antiarrhythmic drugs and 10.5% with AF controlled with antiarrhythmic drugs). Only 4.6% continued to have drug-resistant AF. It was possible to safely discontinue anticoagulation in a substantial proportion of patients with no recurrence in the year after ablation (CHADS score ≤2, stroke incidence of 0.06% per year). The procedure-related complication rate was very low.
CONCLUSIONS: Pulmonary vein isolation is safe and efficacious for long-term maintenance of sinus rhythm and control of symptoms in patients with drug-resistant AF. It obviates the need for antiarrhythmic drugs, negative dromotropic agents, and anticoagulants in a substantial proportion of patients.
Authors:
Ayman A Hussein; Walid I Saliba; David O Martin; Mandeep Bhargava; Minerva Sherman; Christina Magnelli-Reyes; Mohammed Chamsi-Pasha; Seby John; Michelle Williams-Adrews; Bryan Baranowski; Thomas Dresing; Thomas Callahan; Mohamed Kanj; Patrick Tchou; Bruce D Lindsay; Andrea Natale; Oussama Wazni
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2011-04-14
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  4     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-06-15     Completed Date:  2011-09-01     Revised Date:  2012-02-03    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  271-8     Citation Subset:  IM    
Affiliation:
Center for Atrial Fibrillation, the Cleveland Clinic, OH, USA.
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MeSH Terms
Descriptor/Qualifier:
Atrial Fibrillation / etiology*,  physiopathology,  surgery
Catheter Ablation / methods*
Female
Follow-Up Studies
Heart Rate / physiology*
Humans
Male
Middle Aged
Prospective Studies
Pulmonary Veins / surgery*
Recurrence
Time Factors
Treatment Outcome

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


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