Very long-term outcome following transcatheter ablation of atrial fibrillation. Are results maintained after 10 years of follow up?
Atrial fibrillation (AF) transcatheter ablation is a safe and effective procedure. However, outcome over 10 years of follow-up has never been reported. The aim of this study is to assess outcome, describe predictors of recurrences, and report on quality of life (QoL) the decade after an AF ablation.



Patients referred for AF ablation in a single high volume centre from June 2004 to June 2006 were enrolled and followed in a prospective fashion by yearly clinical assessment and Holter monitoring. Among 255 patients (42.7% paroxysmal AF, 77% males, after a follow-up of 125 ± 7 months), 132 (52%) were arrhythmia-free including (58, 32% after a single procedure) while 27 (10%) progressed to permanent AF. At multivariate analysis, a greater left atrium antero-posterior diameter (HR 1.05 95% CI 1.02-1.09, P = 0.02) related to arrhythmic recurrences, while no increase in blood pressure (HR 0.06 95% CI 0.02-0.20, P = 0.01), BMI (HR 0.06 95% CI 0.02-0.09, P < 0.001), and fasting glucose (HR 0.58 95% CI 0.36-0.92, P = 0.02) during follow-up were protective for arrhythmic recurrences. Overall QoL improved significantly, significantly related to the absence of recurrences, arrhythmic burden reduction and blood pressure, and BMI control (P < 0.001).



The outcome of AF ablation over more than 10 years is characterized by a low incidence of progression towards permanent AF. Greater LA anteroposterior diameter related to arrhythmic recurrences, while blood pressure, BMI, and fasting blood glucose control emerged as predictors of sinus rhythm maintenance. Eventually, QoL improved significantly over the follow-up.
Division of Cardiology, Department of Medical Sciences, "Città della Salute e della Scienza" Hospital, University of Turin, Corso Bramante 88, 10126 Turin, Italy.
Fiorenzo
F
Gaita
Division of Cardiology, Cardinal Massaia Hospital, Corso Dante Alighieri, 202, 14100 Asti, Italy.
Marco
M
Scaglione
Division of Cardiology, Department of Medical Sciences, "Città della Salute e della Scienza" Hospital, University of Turin, Corso Bramante 88, 10126 Turin, Italy.
Alberto
A
Battaglia
Division of Cardiology, Department of Medical Sciences, "Città della Salute e della Scienza" Hospital, University of Turin, Corso Bramante 88, 10126 Turin, Italy.
Mario
M
Matta
Division of Cardiology, Department of Medical Sciences, "Città della Salute e della Scienza" Hospital, University of Turin, Corso Bramante 88, 10126 Turin, Italy.
Cristina
C
Gallo
Division of Cardiology, Department of Medical Sciences, "Città della Salute e della Scienza" Hospital, University of Turin, Corso Bramante 88, 10126 Turin, Italy.
Michela
M
Galatà
Division of Cardiology, Cardinal Massaia Hospital, Corso Dante Alighieri, 202, 14100 Asti, Italy.
Domenico
D
Caponi
Division of Cardiology, Cardinal Massaia Hospital, Corso Dante Alighieri, 202, 14100 Asti, Italy.
Paolo
P
Di Donna
Division of Cardiology, Department of Medical Sciences, "Città della Salute e della Scienza" Hospital, University of Turin, Corso Bramante 88, 10126 Turin, Italy.
Matteo
M
Anselmino
D000200:Action Potentials; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology / Q000601:surgery*; D006339:Heart Rate; D061847:Hospitals, High-Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077982:Progression-Free Survival; D011788:Quality of Life; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome