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Ten-year Ablation Outcomes of Patients With Paroxysmal Atrial Fibrillation Receiving Pulmonary Vein Isolation.

Research paper by Wen-Han WH Cheng, Li-Wei LW Lo, Yenn-Jiang YJ Lin, Shih-Lin SL Chang, Yu-Feng YF Hu, Yuan Y Hung, Fa-Po FP Chung, Jo-Nan JN Liao, Ta-Chuan TC Tuan, Tze-Fan TF Chao, Tseng-Ying TY Tsai, Shin-Huei SH Liu, Shih-Ann SA Chen

Indexed on: 19 Jun '19Published on: 05 Apr '19Published in: Heart Rhythm



Abstract

Pulmonary vein isolation (PVI) is commonly performed in patients with drug-refractory symptomatic paroxysmal atrial fibrillation (PAF). However, the very long-term follow-up result is limited. We aimed to investigate a ten-year ablation outcome in patients with PAF and long-term follow-up results after PVI. This study retrospectively enrolled 176 (131 males, 51.2±12.1 years old) patients with drug-refractory symptomatic PAF who underwent electro-anatomical guided PVI. A ten-year follow-up was completed through medical records or telephonic interviews. Procedural characteristics at index procedures and long-term clinical outcomes were investigated. After a mean follow-up period of 130.0±10.8 months, sinus rhythm was achieved in 58% patients after a single procedure (including 8% patients on anti-arrhythmic medications) and in 88% patients after multiple procedures (including 10% patients on anti-arrhythmic medications). Left atrium (LA) diameter (OR 1.067, 95% CI 1.009-1.127, p=0.023) was the predictor of recurrent atrial tachyarrhythmia (ATa) after a single ablation procedure. The single procedure recurrence rates were similar between circumferential and segmental pulmonary vein isolation (CPVI and SPVI, 59% and 50%, log-rank p=0.251). The recurrence patterns of both groups regarding the role of non-pulmonary vein and pulmonary vein triggers were similar. The single procedure long-term efficacy was modest, with freedom from atrial fibrillation at 10-years being 58%. Those who had enlarged LA diameters have more ATa recurrences. Ten-year single-procedural outcome of the effects of CPVI and SPVI in patients with PAF were similar. Copyright © 2019. Published by Elsevier Inc.

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