title: Efficacy of catheter ablation for atrial fibrillation in patients with a permanent pacemaker for atrioventricular block.
abstract: Catheter ablation has been established to be an effective therapy for drug-refractory paroxysmal AF and is recommended as the treatment of choice for many patients, including those with a permanent pacemaker (PM). However, the clinical efficacy of catheter ablation of paroxysmal AF in patients with a permanent PM for atrioventricular block (AVB) is not clear. Twenty-nine patients with a permanent PM for AVB (AVB + PM group), and 145 age- and gender-matched control patients (on a 1:5 basis) without AVB and without a permanent PM (no-AVB + no-PM group), were included in this study. Atrial fibrillation (AF) recurrence was defined as the occurrence of confirmed atrial tachyarrhythmia lasting more than 30 seconds beyond 3 months after catheter ablation in the absence of any antiarrhythmic treatment. During a mean follow-up period of 14.2 ± 8.6 months (range, 3-30 months), 54 patients (31.0%) developed recurrence of AF. The recurrence rate was higher in the AVB + PM group than in the no-AVB + no-PM group (48.3% versus 27.6%, P = 0.005). Cox regression analysis with adjustment for age, valvular heart disease, AVB and a PM together, left atrial (LA) diameter and PV isolation identified LA diameter (hazard ratio 1.054, 95% confidence interval 1.001-1.110, P = 0.047) and AVB and a PM together (hazard ratio 2.095, 95% confidence interval 1.109-3.960, P = 0.023) as two independent predictors of recurrence of AF. Patients with a permanent PM for AVB were at an increased risk of recurrence of AF after catheter ablation.
authors.affiliation: Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou University.
authors.forename: Jin-Tao
authors.initials: JT
authors.lastname: Wu
authors.forename: Jian-Zeng
authors.initials: JZ
authors.lastname: Dong
authors.forename: Shan-Ling
authors.initials: SL
authors.lastname: Wang
authors.forename: Ying-Jie
authors.initials: YJ
authors.lastname: Chu
authors.forename: Li-Xia
authors.initials: LX
authors.lastname: Wang
authors.forename: Chao-Kuan
authors.initials: CK
authors.lastname: Yang
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery*; D054537:Atrioventricular Block / Q000150:complications*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome