title: Long-term outcomes following high intensity focused ultrasound ablation for atrial fibrillation.
abstract: OBJECTIVE
  The aim of this study is to assess the safety and efficacy of the Epicor high intensity focused ultrasound (St. Jude, Inc.®, Minneapolis, MN, USA) system using seven-day ambulatory electrocardiogram (ECG) monitoring over a two-year follow-up period.
  
  
  METHODS
  One hundred and ten patients undergoing ablation were included from a single center between January 2006 and December 2009. Rhythm was assessed using seven-day ambulatory ECG or permanent pacemaker interrogation. Seventeen patients were lost to follow-up, seven through death. Results were reported according to atrial fibrillation (AF) class preoperatively: paroxysmal, persistent, and long-standing persistent (LSP).
  
  
  RESULTS
  Forty-nine percent of patients remained in sinus rhythm at greater than two years. The percentage of patients in sinus rhythm according to preoperative AF class were 81% (paroxysmal AF), 56% (persistent AF), and 18% (long-standing AF). The class of AF prior to surgery, left atrium size, and body mass index determined the long-term outcome. There were no procedure-related complications.
  
  
  CONCLUSIONS
  We conclude that high intensity focused ultrasound ablation for atrial fibrillation using the Epicor system is safe and effective for surgical patients with paroxysmal AF. The persistent and LSP AF results suggest that alternative ablation strategies should be considered for these patients.
authors.affiliation: Plymouth Hospitals NHS Trust, Plymouth, UK.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Davies
authors.forename: Samer
authors.initials: S
authors.lastname: Bazerbashi
authors.forename: Sanjay
authors.initials: S
authors.lastname: Asopa
authors.forename: Guy
authors.initials: G
authors.lastname: Haywood
authors.forename: Malcolm
authors.initials: M
authors.lastname: Dalrymple-Hay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000601:surgery*; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D057086:High-Intensity Focused Ultrasound Ablation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D013997:Time Factors; D016896:Treatment Outcome