title: Clinical outcome of very late recurrence of atrial fibrillation after catheter ablation of paroxysmal atrial fibrillation.
abstract: BACKGROUND
  High recurrence rate is still a major problem associated with ablation of paroxysmal atrial fibrillation (AF). Most of the recurrences occur within 6 months after ablation. The characteristics of very late recurrent AF (>12 months after ablation) have not been reported.
  
  
  RESULTS
  Two hundred seven patients with drug-refractory AF underwent successful focal ablation or isolation of AF foci. After the first ablation procedure, Holter monitoring and event recorders were used to evaluate symptomatic recurrent AF. A second ablation procedure was recommended if the antiarrhythmic drugs could not control recurrent AF. During long-term follow-up (mean 30 +/- 11 months, up to 51 months), 70 patients had recurrent AF, including 13 patients (6%) with very late (>12 months) recurrent AF (group 1) and 57 patients (28%) with late (within 12 months after ablation) recurrent AF (group 2). Group 1 patients had a significantly lower incidence of multiple (> or = 2) AF foci (23% vs 63%, P = 0.02) than group 2 patients. In addition, the incidence of antiarrhythmic drugs use (38% vs 84%, P = 0.001) to maintain sinus rhythm after the first episode of recurrent AF was significantly lower in group 1 than group 2 patients, and the incidence of a second intervention procedure (8% vs 35%, P = 0.051) tended to be lower in group 1 than group 2 patients.
  
  
  CONCLUSIONS
  The incidence of very late recurrent AF after ablation of paroxysmal AF is very low, and the clinical outcome of patients with very late recurrent AF is benign.
authors.affiliation: Division of Cardiology, Department of Medicine, National Yang-Ming University, School of Medicine, Taipei Veterans General Hospital, Taiwan.
authors.forename: Ming-Hsiung
authors.initials: MH
authors.lastname: Hsieh
authors.forename: Ching-Tai
authors.initials: CT
authors.lastname: Tai
authors.forename: Chin-Feng
authors.initials: CF
authors.lastname: Tsai
authors.forename: Wei-Shiang
authors.initials: WS
authors.lastname: Lin
authors.forename: Yung-Kuo
authors.initials: YK
authors.lastname: Lin
authors.forename: Hsuan-Ming
authors.initials: HM
authors.lastname: Tsao
authors.forename: Jin-Long
authors.initials: JL
authors.lastname: Huang
authors.forename: Kwo-Chang
authors.initials: KC
authors.lastname: Ueng
authors.forename: Wen-Chung
authors.initials: WC
authors.lastname: Yu
authors.forename: Paul
authors.initials: P
authors.lastname: Chan
authors.forename: Yu-An
authors.initials: YA
authors.lastname: Ding
authors.forename: Mau-Song
authors.initials: MS
authors.lastname: Chang
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery*; D017115:Catheter Ablation; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D012008:Recurrence; D012086:Reoperation; D013318:Stroke Volume / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone