title: [Long-term results of radiofrequency catheter ablation of long-lasting persistent atrial fibrillation: five years of follow-up].
abstract: OBJECTIVE
  To evaluate long-term results of radiofrequency catheter ablation (RFA) vs. rate-control strategy in patients with long-lasting persistent atrial fibrillation (AF) METHODS: We assessed 5-years results in 66 patients (53.3+/-12.3 years old, 8 women) with long-lasting persistent AF who underwent RFA (ablation group), as well as in age-gender-AF duration-matched patients who were treated with rate-control strategy (rate-control group).The ablation strategy consisted of wide-area circumferential lines around pulmonary veins, roof lines and extensive RFA of the left atrial substrate modification using a three-dimensional mapping system. Incidence of sinus rhythm (SR) maintenance, death, stroke, myocardial infarction (MI), worsening of heart failure (NYHA) were evaluated after 5 years of follow-up.
  
  
  RESULTS
  After 5 years of follow up SR was present in 38 (56%) of 42 who were under follow up patients of ablation group and all patients had AF in rate-control group (95% CI 0.02247-0.3598; p=0.0001). Seventeen (27%) patients of ablation group continued to take atniarrhythmic drugs. 29 (44%) patients of ablation group vs. 48 (73%) patients of rate-control group received warfarin (95% CI 0.442-1.1; p=0.046) at five years of follow up. After five years of follow up the incidence of MI, stroke, worsening of heart failure functional class, and death in the ablation/rate-control groups were 0%/7.5% (95% CI 0.05247-0.30898; p=0,006), 0%/9% (95% CI 0.08903-0.32561; p=0.001), 6%/25% (95% CI 0.147-0.894; p=0.006), and 0.02%/0%, respectively.
  
  
  CONCLUSIONS
  In patients with long-lasting persistent AF ablation strategy results in stable SR in the majority of patients, and decreased incidence of cardiovascular events compared with rate-control strategy during up to 5 years of follow-up.
authors: A V
authors: AV
authors: Ardashev
authors: E G
authors: EG
authors: Zheliakov
authors: D V
authors: DV
authors: Dupliakov
authors: A V
authors: AV
authors: Konev
authors: M S
authors: MS
authors: Rybachenko
authors: V L
authors: VL
authors: Glukhova
authors: G A
authors: GA
authors: Golovina
authors: M A
authors: MA
authors: Skuratova
authors: V A
authors: VA
authors: Fin'ko
authors: Iu N
authors: IuN
authors: Belenkov
mesh_terms: D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D057186:Comparative Effectiveness Research; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000145:classification / Q000175:diagnosis / Q000503:physiopathology; D012426:Russia; D013995:Time; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents