Good responders to catheter ablation for long-standing persistent atrial fibrillation: Clinical and genetic characteristics.
Radiofrequency catheter ablation (RFCA) for long-standing persistent atrial fibrillation (L-PeAF) is challenging and has a relatively high recurrence rate. We explored clinical and genetic characteristics associated with being good responders (no early or clinical recurrence within 12 months in the absence of anti-arrhythmic drugs) to RFCA among patients with L-PeAF.



Of 1319 patients in the Yonsei AF Ablation Cohort, this study included 141 consecutive patients with L-PeAF (80.9% male, age 57.8±9.7 years) who were followed >12 months after RFCA.



During 25 (19-35) months follow-up, the recurrence rate was 39%, and 38 patients (27%) were categorized as good responders, those had a shorter AF duration (p=0.010), and smaller left atrial (LA) size (p=0.033) than others. The rs2106216 (16q22/ZFHX3) genetic polymorphism was independently associated with being a good responder in multivariate analysis (adjusted OR=2.70, 95% CI 1.41-5.14, p=0.003), after adjusting for LA size and AF duration. The rs2106261 had predictive value for clinical recurrence of AF after RFCA among patients with an AF duration 12-65 months (log rank, p=0.025).



Despite a relatively high recurrence rate after RFCA for L-PeAF, patients with a shorter AF duration and smaller LA size showed a more favorable outcome. The rs2106216 polymorphism (ZFHX3) was independently associated with being good responders to RFCA for L-PeAF, especially with AF duration 12-65 months.
Yonsei University Health System, Seoul, Republic of Korea.
Jin-Kyu
JK
Park
Cardiovascular Genome Center, Yonsei University Health System, Seoul, Republic of Korea.
Ji-Young
JY
Lee
Yonsei University Health System, Seoul, Republic of Korea.
Pil-Sung
PS
Yang
Yonsei University Health System, Seoul, Republic of Korea.
Tae-Hoon
TH
Kim
DNA Link Incorporation, Seoul, Republic of Korea.
Eunsoon
E
Shin
Yonsei University Health System, Seoul, Republic of Korea.
Junbeom
J
Park
Yonsei University Health System, Seoul, Republic of Korea.
Jae-Sun
JS
Uhm
Yonsei University Health System, Seoul, Republic of Korea.
Boyoung
B
Joung
Yonsei University Health System, Seoul, Republic of Korea.
Moon-Hyoung
MH
Lee
Yonsei University Health System, Seoul, Republic of Korea; Cardiovascular Genome Center, Yonsei University Health System, Seoul, Republic of Korea. Electronic address: hnpak@yuhs.ac.
Hui-Nam
HN
Pak
D001281:Atrial Fibrillation / Q000235:genetics* / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D005260:Female; D005838:Genotype; D006325:Heart Atria / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020641:Polymorphism, Single Nucleotide; D011183:Postoperative Complications; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome
Ablation; Genetic polymorphism; Long-standing persistent atrial fibrillation