Ablation of paroxysmal and persistent atrial fibrillation: 1-year follow-up through continuous subcutaneous monitoring.
BACKGROUND
The aim of this prospective observational study was to identify responders to ablation through continuous subcutaneous monitoring for 1 year after ablation in patients with paroxysmal atrial fibrillation (PAF) or persistent AF (PersAF).


METHODS
Patients with symptomatic drug refractory AF were enrolled. Real-time three-dimensional (3D) left atrium maps were reconstructed by using a nonfluoroscopic navigation system (CARTO, Biosense-Webster Inc., Diamond Bar, CA, USA). The ipsilateral left and right pulmonary veins (PVs) were encircled in 1 lesion line by circumferential PV isolation. All patients were implanted with Reveal XT (Medtronic Inc.) for continuous AF monitoring and data collected every month during the 12-month follow-up.


RESULTS
We enrolled 129 patients (56 ± 9 years, 102 males), all of whom were followed-up for 12 months after the last ablation procedure: 58 (45%) had a history of PersAF. After only 1 ablation procedure, 76 (59%) of the 129 patients were AF-free at 12-month: 48 out of 71 (68%) in the PAF group and 28 out of 58 (48%) in the PersAF group. After 1 or more ablation procedures, 94 (73%) of the 129 patients were AF-free 12 months after the last procedure: 57 out of 71 (80%) in the PAF group and 37 out of 58 (64%) in the PersAF group.


CONCLUSIONS
Ablation is highly effective in treating AF, as assessed through detailed 1-year continuous monitoring: success rate is higher in PAF than in PersAF patients. The use of subcutaneous monitors is a valuable means of identifying responders and nonresponders, and can potentially guide antiarrhythmic and antithrombotic therapies.
State Research Institute of Circulation Pathology, Novosibirsk, Russia. e.pokushalov@gmail.com
Evgeny
E
Pokushalov
Alexander
A
Romanov
Giorgio
G
Corbucci
Sergey
S
Artyomenko
Alex
A
Turov
Natalya
N
Shirokova
Alexander
A
Karaskov
D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D018780:Body Surface Potential Mapping / Q000295:instrumentation* / Q000379:methods; D017115:Catheter Ablation / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods; D011446:Prospective Studies; D040521:Subcutaneous Tissue / Q000502:physiology*; D016896:Treatment Outcome