Radiofrequency ablation of paroxysmal atrial fibrillation: factors determining long-term clinical efficacy.
BACKGROUND
Most of the studies on this subject have reported predictors of recurrence of atrial fibrillation after catheter ablation with relatively short follow-up periods.


OBJECTIVE
To retrospectively evaluate predictors of long-term recurrence of paroxysmal atrial fibrillation (AF) in patients undergoing pulmonary vein isolation following one single procedure.


METHODS
The authors studied a total of 139 patients (102 men; mean age of 55 +/- 12 years) undergoing radiofrequency ablation using the ostial or extra-ostial techniques for left atrial approach, combined or not with cavotricuspid isthmus ablation (CTI). Pre, intra and post-ablation variables were evaluated using univariate and multivariate analyses to determine the predictors of recurrence of AF after one procedure.


RESULTS
After a 33 +/- 12-month follow-up, we observed that a longer time of history of AF, use of more antiarrhythmic drugs, and recurrence of AF within 60 days post-procedure increased the risk of long-term recurrence of AF. On the other hand, the association of atrial flutter and concomitant CTI ablation reduced the risk of recurrence of AF.


CONCLUSIONS
Clinical variables such as time of history of AF and a larger number of antiarrhythmic drugs already used influenced the outcomes of catheter ablation. In patients with associated atrial flutter, simultaneous CTI block significantly reduced the long-term recurrence of atrial fibrillation.
Sartini
Raul José Pádua
RJ
Instituto do Coração de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP - Brasil. sartini@hotmail.com
Scanavacca
Maurício Ibrahim
MI
Sosa
Eduardo
E
Moreira
Luiz Felipe
LF
Lara
Sissy
S
Hardy
Carina
C
Darrieux
Francisco
F
Hachul
Denise
D
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D001282:Atrial Flutter / Q000601:surgery; D017115:Catheter Ablation / Q000379:methods; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents