title: Atrial fibrillation ablation by use of electroanatomical mapping: efficacy and recurrence factors.
abstract: BACKGROUND
  Radiofrequency catheter ablation guided by electroanatomical mapping is currently an important therapeutic option for the treatment of atrial fibrillation. The complexity of the procedure, the several techniques used and the diversity of the patients hinder the reproduction of the results and the indication for the procedure.
  
  
  OBJECTIVE
  To evaluate the efficacy and factors associated with recurrence of atrial fibrillation.
  
  
  METHODS
  Prospective cohort study with consecutive patients submitted to atrial fibrillation ablation treatment guided by electroanatomical mapping. The inclusion criteria were as follows: minimum age of 18 years; presence of paroxysmal, persistent or long-standing persistent AF; AF recording on an electrocardiogram, exercise testing or Holter monitoring (duration longer than 15 minutes); presence of symptoms associated with AF episodes; AF refractoriness to, at least, two antiarrhythmic drugs, one of which being amiodarone, or impossibility to use antiarrhythmic drugs.
  
  
  RESULTS
  The study included 95 patients (age 55 ± 12 years, 84% men, mean CHADS2 = 0.8) who underwent 102 procedures with a median follow-up of 13.4 months. The recurrence-free rate after the procedure was 75.5% after 12 months. Atrial fibrillation recurred as follows: 26.9% of patients with paroxysmal and persistent atrial fibrillation; 45.8% of patients with long-standing persistent atrial fibrillation (p = 0.04). Of the analyzed variables, the increased size of the left atrium has proven to be an independent predictor of atrial fibrillation recurrence after the procedure (HR = 2.58; 95% CI: 1.26-4.89). Complications occurred in 4.9% of the procedures.
  
  
  CONCLUSIONS
  Atrial fibrillation ablation guided by electroanatomical mapping has shown good efficacy. The increase in left atrium size was associated with atrial fibrillation recurrence.
authors.affiliation: Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Porto AlegreRS, Brasil.
authors.forename: Carlos
authors.initials: C
authors.lastname: Kalil
authors.affiliation: Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Porto AlegreRS, Brasil.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bartholomay
authors.affiliation: Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Porto AlegreRS, Brasil.
authors.forename: Anibal
authors.initials: A
authors.lastname: Borges
authors.affiliation: Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Porto AlegreRS, Brasil.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Gazzoni
authors.affiliation: Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Porto AlegreRS, Brasil.
authors.forename: Edimar de
authors.initials: Ed
authors.lastname: Lima
authors.affiliation: Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Porto AlegreRS, Brasil.
authors.forename: Renata
authors.initials: R
authors.lastname: Etchepare
authors.affiliation: Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Porto AlegreRS, Brasil.
authors.forename: Rafael
authors.initials: R
authors.lastname: Moraes
authors.affiliation: Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Porto AlegreRS, Brasil.
authors.forename: Carolina
authors.initials: C
authors.lastname: Sussenbach
authors.affiliation: Fundação Universitária de Cardiologia, Instituto de Cardiologia do Rio Grande do Sul, Porto AlegreRS, Brasil.
authors.forename: Karina
authors.initials: K
authors.lastname: Andrade
authors.affiliation: Fundação Universitária de Cardiologia, Instituto de Cardiologia do Rio Grande do Sul, Porto AlegreRS, Brasil.
authors.forename: Renato
authors.initials: R
authors.lastname: Kalil
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000517:prevention & control / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods*; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D015203:Reproducibility of Results; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome