title: Long-term outcomes (>2 years) of atrial fibrillation ablation using a multi-electrode ablation catheter in patients with paroxysmal atrial fibrillation.
abstract: OBJECTIVE
  Catheter ablation for paroxysmal atrial fibrillation (PAF) is an effective treatment. Favourable outcomes at 6-12 months post-ablation have been reported using the multi-electrode catheter 'pulmonary vein ablation catheter (PVAC)' but little is known about longer term outcomes. There are also limited data on quality of life (QoL) post-atrial fibrillation (AF) ablation beyond 2 years of follow-up.
  
  
  METHODS
  Two hundred three consecutive patients (77 % male, mean age 57.7 ± 11 years) who had a PAF ablation were included. Patients underwent conventional pulmonary vein isolation (PVI) (n = 128) or PVAC ablation (n = 75). Patients' symptoms were scored at baseline, at clinic follow-up and on questionnaire follow-up using the validated Canadian Cardiovascular Society Severity of AF (CCS-SAF) scale. The 'AF Effect on QualiTy of life' (AFEQT) questionnaire was used on questionnaire follow-up.
  
  
  RESULTS
  Mean questionnaire follow-up was 854 ± 176 days with 74 % response rate. The majority of patients (91.6 % overall) were highly symptomatic at baseline with CCS-SAF class 3 or 4 symptoms. CCS-SAF class on follow-up questionnaire decreased significantly from baseline for both groups (mean 1.69 ± 1.7 for PVAC and 1.45 ± 1.5 for PVI, p = 0.001 and p < 0.001, respectively) with no difference between groups (p = 0.52) and the majority being class 0 or 1 (59.9 % overall). Mean AFEQT questionnaire scores were similar between both groups (78.1 ± 25 vs. 82 ± 23, p = 0.35). Total procedure time was significantly shorter in the PVAC group (135 ± 54 vs. 178 ± 43 min, p < 0.001).
  
  
  CONCLUSIONS
  There was a comparable and significant improvement in QoL post-ablation in patients who underwent ablation using PVAC catheter and conventional techniques.
authors.affiliation: Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, CB23 3RE, UK. khangli@hotmail.com
authors.forename: Khang-Li
authors.initials: KL
authors.lastname: Looi
authors.forename: Parag
authors.initials: P
authors.lastname: Gajendragadkar
authors.forename: Tamer
authors.initials: T
authors.lastname: Taha
authors.forename: Maros
authors.initials: M
authors.lastname: Elsik
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Scully
authors.forename: Patrick
authors.initials: P
authors.lastname: Heck
authors.forename: Simon
authors.initials: S
authors.lastname: Fynn
authors.forename: Munmohan
authors.initials: M
authors.lastname: Virdee
authors.forename: David
authors.initials: D
authors.lastname: Begley
mesh_terms: D000704:Analysis of Variance; D000925:Anticoagulants / Q000008:administration & dosage; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D016009:Chi-Square Distribution; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D011788:Quality of Life; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants