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Time to Recurrence of Atrial Fibrillation Influences Outcome Following Catheter Ablation.
MedLine Citation:
PMID:  22982966     Owner:  NLM     Status:  Publisher    
BACKGROUND: Outcome after atrial fibrillation (AF) recurrence following ablation remains poorly characterized. OBJECTIVE: To determine whether the time to recurrence of AF after catheter ablation impacts outcome. METHODS: 439 consecutive patients with AF following catheter ablation were categorized as early recurrence (E) (3-6 months after ablation, 245 patients), late (L) (6-12 months, N=118) and very late (VL) (>12 months, N=76). Subsequent AF frequency (defined as rare if ≤2 episodes or ≤1cardioversion per six month window), response to antiarrhythmic drugs (AAD) and long-term outcome after repeat ablation were evaluated. RESULTS: Subsequent AF episodes were rare in 9% of E, 42% of L and 68% of VL groups (p<0.001). AF was eliminated with AAD in 19% of E, 58% of L and 72% of VL groups in whom AAD were tried (p<0.001). A repeat ablation was performed in 75% of E, 59% of L and 46% of VL recurrence groups (p<0.001). With >1 year follow-up post repeat ablation, 49% of E, 70% of L and 89% of VL groups (p<0.001) had no or rare AF. In multivariate logistic regression, time to recurrence was an independent predictor of rare AF episodes, better response to AAD, and better outcome after repeat ablation. CONCLUSIONS: In patients with AF after ablation, time to recurrence is a major determinant of outcome. Patients with later recurrences are more likely to have sporadic episodes and respond better to AADs and repeat ablation. These results not only suggest pathophysiologic differences but also have implications for counseling patients regarding anticipated outcome.
Larraitz Gaztañaga; David S Frankel; Maria Kohari; Lavanya Kondapalli; Erica S Zado; Francis E Marchlinski
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-13
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Inc.
Electrophysiology Section, Cardiovascular Division, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
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