title: Five-year outcomes after segmental pulmonary vein isolation for paroxysmal atrial fibrillation.
abstract: Most studies evaluating the efficacy of atrial fibrillation (AF) ablation report follow-up periods of 1 year to 2 years, but few report long-term results of > or =5 years after ablation. Therefore, we evaluated the long-term efficacy (i.e., >5 years) of segmental antrum pulmonary vein isolation (PVI) for paroxysmal AF. Seventy-one patients (60 +/- 10 years, 56 men) who underwent PVI for paroxysmal AF from January 1, 2002, to August 31, 2003, were followed for at least 5 years after their index ablation procedure. Five-year outcomes were determined at last clinic visit, by telephone encounters, and by cardiac monitoring when available. After 1 ablation, off antiarrhythmic drugs, 61 patients (86%) were free of symptomatic AF at 12 months, 56 patients (79%) at 24 months, and 40 patients (56%) at 63 +/- 5 months. Sixteen patients (22.5%) had AF recur after the second year after ablation. Thirty-one patients underwent > or =1 repeat ablations (1.6 +/- 0.9 per patient). After multiple procedures, 58 patients (81%) were free of symptomatic AF off antiarrhythmic drugs at 63 +/- 5 months after their initial ablation; however, in 18 of these patients who received multiple ablation procedures, mean duration of follow-up after the last ablation was only 13.5 +/- 2.1 months. In conclusion, overall 5-year outcome after PVI for paroxysmal AF is similar to that previously reported for shorter-term follow-up (< or =2 years). However, late recurrences >2 years after initial ablation were frequent, and repeat ablation was often required to maintain freedom from symptomatic AF.
authors.affiliation: Division of Cardiology, and Cardiac Electrophysiology Program, University of California, San Diego, California. drsawhney@gmail.com
authors.forename: Navinder
authors.initials: N
authors.lastname: Sawhney
authors.forename: Ramtin
authors.initials: R
authors.lastname: Anousheh
authors.forename: Wei-Chung
authors.initials: WC
authors.lastname: Chen
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Narayan
authors.forename: Gregory K
authors.initials: GK
authors.lastname: Feld
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000517:prevention & control* / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome