Outcomes in patients requiring cardioversion following catheter ablation of atrial fibrillation.
BACKGROUND
Early recurrence of atrial tachyarrhythmias is commonly noted after catheter ablation of atrial fibrillation (AF). The long-term outcomes of patients who require cardioversion for persistent AF after AF ablation is not known. This study reports the outcomes of patients who underwent cardioversion for persistent AF or atrial flutter following an AF ablation procedure.


METHODS
The patient population comprised 55 patients (mean age 58 +/- 10 years, 35% paroxysmal) who underwent catheter ablation of AF and subsequently required electrical cardioversion for persistent AF (45 patients) or atrial flutter (10 patients). Cardioversion was defined as early (within 90 days of the ablation procedure) or late (between 90 and 180 days following ablation).


RESULTS
The mean follow-up duration was 15 +/- 8 months. Forty-six of the 55 patients (84%) patients experienced recurrence during follow-up. The average time to recurrence after cardioversion was 37 days. Of the 55 patients, 8 (15%) patients had a complete success, 11 (20%) patients had a partial success and 36 patients (65%) had a failed outcome. Seven of the 43 patients (16%) who underwent early cardioversion had a complete success as opposed to one of 12 patients (8%) who underwent late cardioversion (P = 0.49).


CONCLUSIONS
This study shows that >80% of patients who undergo cardioversion for persistent AF or atrial flutter after AF ablation have recurrence. The timing of cardioversion did not affect the outcome. These findings allow clinicians to provide realistic expectations to patients regarding the long-term outcome and/or requirement for a second ablation procedure.
Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Karuna
K
Chilukuri
Jonathan
J
Dukes
Darshan
D
Dalal
Joseph E
JE
Marine
Charles A
CA
Henrikson
Daniel
D
Scherr
Sunil
S
Sinha
Ronald
R
Berger
Alan
A
Cheng
Saman
S
Nazarian
David
D
Spragg
Hugh
H
Calkins
D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000517:prevention & control*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D004554:Electric Countershock / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D055502:Secondary Prevention; D016896:Treatment Outcome