Clinical predictors of noninducibility of sustained atrial fibrillation after pulmonary vein isolation.
BACKGROUND
Noninducibility of sustained atrial fibrillation (AF) after pulmonary vein isolation (PVI) has been shown to be associated with a better clinical outcome. We evaluated the role of clinical variables that could predict noninducibility of sustained AF after PVI.


RESULTS
Data were collected prospectively from 181 patients (153 male; age 54 +/- 9 years) referred for ablation of drug-refractory symptomatic paroxysmal AF (duration < or =7 days). Clinical variables were evaluated with regard to their ability of predicting noninducibility of sustained AF (< or =10 minutes) after PVI. Univariate analysis was performed on all collected variables followed by multivariate analysis for variables showing a P value <0.1. After PVI, sustained AF was noninducible in 97 (54%) patients. The following clinical variables showed a significant difference between the groups: body weight, longest AF episode, duration of AF history, presence or absence of structural heart disease, left ventricular (LV) hypertrophy, prior cardioversion, left atrial (LA) parasternal, and longitudinal diameters and LV diameters. On multivariate analysis, three independent predictors of noninducibility were identified: a shorter duration of AF episodes (AF <12 hours: RR 0.01 (0.002-0.06), P < 0.001; AF 12-48 hours: RR 0.07 (0.01-0.37), P = 0.001); LA longitudinal diameter <57 mm (RR 0.33 (0.13-0.82), P = 0.016); and absence of LV hypertrophy (RR 0.15 (0.04-0.63), P = 0.01).


CONCLUSIONS
Shorter AF episodes, smaller LA longitudinal diameter, and absence of LV hypertrophy are independent predictors of noninducibility of sustained AF after PVI.
Rotter
Martin
M
Hôpital Cardiologique du Haut-Lévêque, and the Université Victor Segalen Bordeaux II, Bordeaux, France. martin.rotter@gmx.ch
Jaïs
Pierre
P
Garrigue
Stephane
S
Sanders
Prashanthan
P
Hocini
Mélèze
M
Hsu
Li-Fern
LF
Takahashi
Yoshihide
Y
Rostock
Thomas
T
Sacher
Fréderic
F
Clementy
Jacques
J
Haïssaguerre
Michel
M
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000628:therapy*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011667:Pulmonary Veins; D013997:Time Factors; D016896:Treatment Outcome