title: Catheter ablation of persistent atrial fibrillation with and without a history of paroxysmal atrial fibrillation.
abstract: BACKGROUND
  It is unclear whether a history of paroxysmal atrial fibrillation (PAF) would impact the effect of catheter ablation on persistent atrial fibrillation (AF). This study aimed to compare the effect of catheter ablation on persistent AF with and without a history of PAF.
  
  
  METHODS
  One hundred and eighty-three patients underwent catheter ablation of persistent AF lasting for > 1 month and were reviewed. Patients were divided into two groups according to whether they had a history of PAF or not. Group I consisted of persistent AF patients with a history of PAF, and group II consisted of persistent AF patients without such a history. All patients received catheter ablation focused on pulmonary vein isolation and were observed for arrhythmia recurrences, which were defined as documented episodes of AF or atrial tachycardia after a blanking period of 3 months.
  
  
  RESULTS
  One hundred and three patients (60.9%) in group I and sixty-six patients (39.1%) in group II were successfully followed and included in analysis. There were no significant differences in clinical and echocardiographic characteristics between both groups except for a younger age and more male patients in group II. After (15.5 ± 10.7) months of follow-up, 59 (57.3%) patients in group I and 49 (74.2%) patients in group II maintained sinus rhythm free of anti-arrhythmia drugs (P = 0.025). Multivariate analyses found left atrial anteroposterior diameter (P = 0.006) and persistent AF with a history of PAF (OR 1.792, 95%CI 1.019 - 3.152; P = 0.043) as the only independent statistical predictors of arrhythmia recurrences.
  
  
  CONCLUSIONS
  The arrhythmia recurrence rate of catheter ablation based on pulmonary vein isolation in persistent AF with a history of PAF was higher than those without a history of PAF.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Cheng-long
authors.initials: CL
authors.lastname: Miao
authors.forename: Xian-dong
authors.initials: XD
authors.lastname: Yin
authors.forename: Jian-zeng
authors.initials: JZ
authors.lastname: Dong
authors.forename: Xing-peng
authors.initials: XP
authors.lastname: Liu
authors.forename: Rong-hui
authors.initials: RH
authors.lastname: Yu
authors.forename: De-yong
authors.initials: DY
authors.lastname: Long
authors.forename: Ri-bo
authors.initials: RB
authors.lastname: Tang
authors.forename: Cai-hua
authors.initials: CH
authors.lastname: Sang
authors.forename: Chang-sheng
authors.initials: CS
authors.lastname: Ma
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011667:Pulmonary Veins / Q000601:surgery; D012008:Recurrence