title: Twelve-year follow-up of catheter ablation for atrial fibrillation: A prospective, multicenter, randomized study.
abstract: Randomized and controlled studies have reported the effect of catheter ablation (CA) for atrial fibrillation (AF) over a follow-up of 12-24 months.
  
  
  
  We report on the effect of CA plus antiarrhythmic drugs in comparison with antiarrhythmic drugs alone on the maintenance of sinus rhythm over 12-year follow-up.
  
  
  
  We extended the follow-up duration of the 137 patients who were enrolled in the Catheter Ablation for the Cure of Atrial Fibrillation Study between February 1, 2002, and June 30, 2003, and randomized to antiarrhythmic drugs (control group) or antiarrhythmic drugs plus CA (ablation group). The primary end point was time to first symptomatic or asymptomatic recurrence of atrial arrhythmia lasting >30 seconds during follow-up.
  
  
  
  During follow-up, 19 of 68 (27.9%; 95% confidence interval [CI] 18.7%-39.6%) ablation group patients and 3 of 69 (4.3%; 95% CI 1.49%-12.0%) control group patients did not experience any relapse of atrial tachyarrhythmia (P < .001). The Kaplan-Meier analysis performed to determine the probability of survival free from atrial arrhythmias showed a statistical difference in favor of the ablation group (log-rank, P < .001). The effect of CA was consistent in both patients with paroxysmal AF and those with persistent AF. In the multivariate Cox regression analysis, belonging to the control group (hazard ratio 2.95; 95% CI 1.896-4.726; P < .001) and longer time since first AF episode (hazard ratio 1.004; 95% CI 1.002-1.084; P = .041) were predictors of atrial tachyarrhythmia recurrence.
  
  
  
  In patients with paroxysmal and persistent AF, CA significantly increased time to first recurrence of atrial arrhythmias during 12-year follow-up.
authors.affiliation: Dipartimento di Scienze Cardiache, Toraciche e Vascolari, Università degli Studi di Padova, Padova, Italy; Ospedale Civile, via Mariutto, Mirano (VE), Italy. Electronic address: bertagliaferro@alice.it.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Bertaglia
authors.affiliation: Ospedale Civile, via Battitore, Ciriè, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Senatore
authors.affiliation: Dipartimento di Scienze Cardiache, Toraciche e Vascolari, Università degli Studi di Padova, Padova, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: De Michieli
authors.affiliation: Casa di Cura San Michele, Maddaloni (CE), Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: De Simone
authors.affiliation: Ospedale Civile, via Battitore, Ciriè, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Amellone
authors.affiliation: Dipartimento di Scienze Cardiache, Toraciche e Vascolari, Università degli Studi di Padova, Padova, Italy.
authors.forename: Sonia
authors.initials: S
authors.lastname: Ferretto
authors.affiliation: Casa di Cura San Michele, Maddaloni (CE), Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: La Rocca
authors.affiliation: Ospedale Civile, via Battitore, Ciriè, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Giuggia
authors.affiliation: Dipartimento di Scienze Cardiache, Toraciche e Vascolari, Università degli Studi di Padova, Padova, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Corrado
authors.affiliation: Ospedale Civile, via Mariutto, Mirano (VE), Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Zoppo
authors.affiliation: Casa di Cura San Michele, Maddaloni (CE), Italy,; Clinica Mediterranea, via Orazio, Napoli, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Stabile
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012008:Recurrence; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: Antiarrhythmic drugs; Atrial fibrillation; Catheter ablation; Long-term follow-up; Randomized study