title: Long-term outcomes after ablation of persistent atrial fibrillation: an observational study over 6 years.
abstract: To address the limited long-term outcome data for catheter ablation (CA) of persistent atrial fibrillation (PeAF), we analysed consecutive ablations performed at our centre from 1 January 2008 to 31 December 2010 and followed patients prospectively until January 2014.
  
  
  
  Both arrhythmia recurrence and symptom relief were assessed. Follow-up data were collected from hospital records, supplemented by data from general practitioners and referring hospitals. At the end of the follow-up period, all patients were contacted by phone to determine their up-to-date clinical condition.
  
  
  
  188 consecutive patients with PeAF (157 male, mean age 57.3±9.7 years, 20% with long-standing PeAF) underwent a mean of 1.75 procedures (range 1-4). Telephone follow-up was achieved for 77% of surviving patients. Over a mean follow-up of 46±16 months (range 4-72), 139 (75%) patients experienced arrhythmia recurrence after a single procedure and 90 (48%) after their final procedure. Median time to first recurrence was 210 days (range 91-1850). 71% of recurrences were within the first year following ablation and 91% within 2 years. At final follow-up, 82% of patients reported symptomatic improvement. 7 (2.3%) major complications occurred, and there was no procedure-related death or stroke.
  
  
  
  CA for PeAF is safe with a low rate of complications. Over a follow-up period of up to 6 years, a large majority of patients experience significant symptomatic improvement but recurrence after the initial procedure is the norm rather than the exception. 2 years' follow-up is sufficient to observe 90% of AF recurrences, but recurrence can occur even after 5 years' remission.
authors.affiliation: Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, Liverpool, UK; Royal Melbourne Hospital, Melbourne, Australia.
authors.forename: Gareth J
authors.identifier: 0000-0002-1935-8155
authors.initials: GJ
authors.lastname: Wynn
authors.affiliation: Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital , Liverpool , UK.
authors.forename: Moutaz
authors.initials: M
authors.lastname: El-Kadri
authors.affiliation: Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital , Liverpool , UK.
authors.forename: Iram
authors.initials: I
authors.lastname: Haq
authors.affiliation: Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, Liverpool, UK; National Heart and Lung Institute, Imperial College London, London, UK.
authors.forename: Moloy
authors.initials: M
authors.lastname: Das
authors.affiliation: Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital , Liverpool , UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Modi
authors.affiliation: Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital , Liverpool , UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Snowdon
authors.affiliation: Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital , Liverpool , UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Hall
authors.affiliation: Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital , Liverpool , UK.
authors.forename: Johan Ep
authors.initials: JE
authors.lastname: Waktare
authors.affiliation: Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital , Liverpool , UK.
authors.forename: Derick M
authors.initials: DM
authors.lastname: Todd
authors.affiliation: Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, Liverpool, UK; National Heart and Lung Institute, Imperial College London, London, UK.
authors.forename: Dhiraj
authors.initials: D
authors.lastname: Gupta
keywords: Cardiac arrhythmias and resuscitation science; Electrophysiology