[Long-term follow-up of right atrial multilinear high-frequency ablation in the treatment of recurrent paroxysmal atrial fibrillation].
OBJECTIVE
To investigate the long-term follow-up after right atrial compartmentalization using radiofrequency catheter ablation to treat recurrent paroxysmal atrial fibrillation.


METHODS
33 patients (eight women / 25 men, mean age 56.1+/-9.9 years) with highly symptomatic recurrent paroxysmal atrial fibrillation and mostly unresponsive to antiarrhythmic drugs were enrolled in this prospective study. All patients underwent radiofrequency catheter ablation, including right atrial compartmentalization and ablation of the right atrial isthmus region. The primary goal during follow-up was documentation of arrhythmia-related symptoms using a SF-36 quality-of-life questionnaire.


RESULTS
During a mean follow-up of 2.1 years 21 % of patients were free of a relapse under continued antiarrhythmic medication, 79 % suffered at least from one period of atrial fibrillation. According to the underlying heart disease patients classified as "lone atrial fibrillation" (40 % without a relapse) showed improvement particularly compared to patients with coronary heart disease (10 % without a relapse). In the group of patients with a relapse of atrial fibrillation the mean of duration of an arrhythmic episode decreased significantly from 10.6 to 2.3 hours under continued administration of antiarrhythmic drugs (p = 0.01), as did the number of episodes, from 2.2 to 1.9/week.


CONCLUSIONS
Despite of the high rate of clinical relapse, patients can profit due to an improved responsiveness to antiarrhythmic drugs after ablation. Right atrial compartmentalization should not be understood as a causal therapy but as an approach to a symptomatic form of hybrid therapy.
Dierkes
S
S
Medizinische Klinik und Poliklinik B, Klinik für Kardiologie, Pneumologie und Angiologie, Heinrich Heine-Universität, Düsseldorf.
Hennersdorf
M G
MG
Vester
E G
EG
Perings
C
C
D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D017115:Catheter Ablation; D003627:Data Interpretation, Statistical; D004562:Electrocardiography; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D011795:Surveys and Questionnaires; D013997:Time Factors
D000889:Anti-Arrhythmia Agents