title: Long-term follow-up of persistent atrial fibrillation ablation using termination as a procedural endpoint.
abstract: OBJECTIVE
  Catheter ablation of long-lasting persistent atrial fibrillation (AF) has been performed with varying results using a combination of different techniques. Whether arrhythmia termination during ablation is associated with an improved clinical outcome is controversial.
  
  
  RESULTS
  In this prospective study, 153 consecutive patients (56 +/- 10 years) underwent catheter ablation of persistent AF (25 +/- 33 months) using a stepwise approach with the desired procedural endpoint being AF termination. Repeat ablation was performed for patients with recurrent AF or atrial tachycardia (AT) after a 1 month blanking period. A minimum follow-up of 12 months with repeated Holter monitoring was performed. Atrial fibrillation was terminated in 130 patients (85%). There was a lower incidence of AF in those patients in whom AF was terminated during the index procedure compared with those who had not (5 vs. 39% P < 0.0001, mean follow-up 32 +/- 11 months). Seventy-nine patients underwent repeat procedures: 64/130 in the termination group (6 AF, 58 AT) and 15 in the non-termination group (9 AF, 7 AT). After repeat ablation, sinus rhythm was maintained in 95% in whom AF was terminated compared with 52% in those in whom AF could not be terminated.
  
  
  CONCLUSIONS
  Procedural termination of long-lasting AF by catheter ablation alone is associated with an improved outcome.
authors.affiliation: Service de Rythmologie, Hôpital Cardiologique du Haut Lévêque, Avenue de Magellan, 33604 Bordeaux, Pessac, France.
authors.forename: Mark D
authors.initials: MD
authors.lastname: O'Neill
authors.forename: Matthew
authors.initials: M
authors.lastname: Wright
authors.forename: Sébastien
authors.initials: S
authors.lastname: Knecht
authors.forename: Pierre
authors.initials: P
authors.lastname: Jaïs
authors.forename: Mélèze
authors.initials: M
authors.lastname: Hocini
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Anders
authors.initials: A
authors.lastname: Jönsson
authors.forename: Frédéric
authors.initials: F
authors.lastname: Sacher
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Matsuo
authors.forename: Kang Teng
authors.initials: KT
authors.lastname: Lim
authors.forename: Leonardo
authors.initials: L
authors.lastname: Arantes
authors.forename: Nicolas
authors.initials: N
authors.lastname: Derval
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lellouche
authors.forename: Isabelle
authors.initials: I
authors.lastname: Nault
authors.forename: Pierre
authors.initials: P
authors.lastname: Bordachar
authors.forename: Jacques
authors.initials: J
authors.lastname: Clémenty
authors.forename: Michel
authors.initials: M
authors.lastname: Haïssaguerre
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000628:therapy*; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation; D016896:Treatment Outcome