Long-term outcome of right and left atrial radiofrequency ablation in patients with persistent atrial fibrillation.
OBJECTIVE
To investigate the clinical outcome of right and left atrial radiofrequency ablation after the first 12 months in patients with drug-refractory persistent atrial fibrillation (AF), and to identify predictors of long-term success.


METHODS
We analyzed the clinical outcome of 74 consecutive patients with a follow-up >12 months who underwent right and left atrial ablation for persistent AF. Patients who did not present symptomatic or asymptomatic atrial tachyarrhythmias (AT) lasting >30 seconds after the first 3 months of follow-up were defined responders to pulmonary veins ablation.


RESULTS
After a mean follow-up of 20.2 +/- 6.3 months (12-36), 52/74 (70%) patients were deemed responders. AT relapsed within the first 12 months in 19/74 (26%) patients (17 AF and 2 left atrial flutter). Among those patients who did not relapse within the first 12 months, only 3 patients (5%) presented AF after the first year of follow-up. At the multivariate analysis presence of early AT relapse and history of AF >7 years inversely correlated with a successful long-term clinical outcome.


CONCLUSIONS
Right and left atrial ablation, alone or in association with antiarrhythmic drugs, prevented AT relapses in 70% of patients with drug-refractory persistent AF also after the first 12 months. Presence of AT relapse within the first 3 months and history of AF >7 years identified patients with a lower probability of successful long-term clinical outcome.
Bertaglia
Emanuele
E
Dipartimento di Cardiologia, Ospedale Civile di Mirano (VE), Italy. cardiologia.mirano@ulss13mirano.ven.it
Stabile
Giuseppe
G
Senatore
Gaetano
G
Turco
Pietro
P
Donnici
Giovanni
G
De Simone
Antonio
A
Fazzari
Massimo
M
Zerbo
Francesca
F
Pascotto
Pietro
P
D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D012008:Recurrence; D016896:Treatment Outcome