title: Procedural arrhythmia termination and long-term single-procedure clinical outcome in patients with non-paroxysmal atrial fibrillation.
abstract: BACKGROUND
  The influence of procedural arrhythmia termination on long-term single-procedure clinical outcome in patients with non-paroxysmal atrial fibrillation (AF) remains controversial.
  
  
  METHODS
  An individualized stepwise ablation strategy was used in 200 consecutive patients with non-paroxysmal AF who underwent first-time radiofrequency catheter ablation, with pulmonary vein isolation and sinus rhythm (SR) restoration as the primary endpoints.
  
  
  RESULTS
  SR was restored by ablation in 94 patients, including 32 with AF directly and 62 with intermediate atrial tachycardia (AT). Cardioversion was performed to restore SR in 106 patients, including 31 with intermediate AT, and 75 with sustained AF. During a mean follow-up of 50.0 ± 9.3 months, single-procedure success was achieved in 99 (49.5%) patients. There was a significant difference in long-term success between patients with SR restoration by ablation and by cardioversion (63.8% vs 36.8%; P < 0.001), but not between patients with AF termination by ablation and by cardioversion (53.6% vs 42.7%; P = 0.146). SR restoration by ablation (odds ratio = 3.032; 95% confidence interval = 1.703-5.398; P < 0.001) was the only predictor of single-procedure success by logistic regression analyses. In patients with intermediate AT (n = 93), AT termination by ablation was associated with a higher success rate than AT termination by cardioversion (62.9% vs 22.6%; P < 0.001).
  
  
  CONCLUSIONS
  SR restoration and AT termination by ablation were both associated with an improved long-term single-procedure clinical outcome in patients with non-paroxysmal AF.
authors.affiliation: Department of Cardiology, Shanghai First People's Hospital, School of Medicine, Jiaotong University, Shanghai, China.
authors.forename: Genqing
authors.initials: G
authors.lastname: Zhou
authors.forename: Songwen
authors.initials: S
authors.lastname: Chen
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
authors.forename: Feng
authors.initials: F
authors.lastname: Zhang
authors.forename: Weidong
authors.initials: W
authors.lastname: Meng
authors.forename: Yiwen
authors.initials: Y
authors.lastname: Yan
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Lu
authors.forename: Yong
authors.initials: Y
authors.lastname: Wei
authors.forename: Shaowen
authors.initials: S
authors.lastname: Liu
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D004554:Electric Countershock / Q000009:adverse effects; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013617:Tachycardia, Supraventricular / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: arrhythmia termination; atrial fibrillation; atrial tachycardia; catheter ablation; pulmonary vein isolation