Ipsilateral circumferential radiofrequency ablation of atrial fibrillation with irrigated tip catheter: long-term outcome and pre-procedural predictors.

Abstract

BACKGROUND:

Predictors of long-term outcome of atrial fibrillation (AF) ablation are unknown. The predictors of 5-year follow-up (FU) after single ipsilateral circumferential antrum pulmonary vein isolation (PVI) with irrigated tip catheter were investigated.

METHODS AND RESULTS:

In 356 patients (74% male) with AF (44% paroxysmal AF [PAF]) PVI was performed. Success was defined as absence of AF, atrial flutter or tachycardia (AFLAT) recurrence. A total of 161 patients (45%) were free of AFLAT. The univariate predictors of AFLAT recurrence were: type of AF (non-PAF vs. PAF, P=0.0001), size of LA (normalized left atrium area [NLA] ≥11.5 vs. NLA <11.5, P=0.0001), renal function (glomerular filtration rate [GFR] <68ml/min vs. GFR ≥68ml/min, P=0.001) and hypertension (HT vs. no HT, P=0.025). The independent predictors of AFLAT-free survival were non-PAF (hazard ratio [HR], 1.67; 95% confidence interval [CI]: 1.23-2.26, P=0.0005), NLA ≥11.5 (HR, 1.40; 95% CI: 1.03-1.90, P=0.007) and GFR <68ml/min (HR, 1.70; 95% CI: 1.21-2.37, P=0.008).

CONCLUSIONS:

Single PVI results in a moderate success rate in patients with AF during 5-year FU without the use of a 3-D mapping system. Higher success was observed in patients with PAF, non-enlarged LA and good renal function.

• Authors: Maciej Wójcik, Damir Erkapic, Alexander Berkowitsch, Sergey Zaltsberg, Harald Greiss, Jörn Schmitt, Dimitri Pajitnev, Stefan Lehinant, Johannes Rixe, Christian W Hamm, Heinz F Pitschner, Malte Kuniss, Thomas Neumann
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 77 Issue 9 Pg. 2280-7 ( 2013) ISSN: 1347-4820 [Electronic] Japan
• PMID: 23811678 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Atrial Fibrillation (mortality, surgery)
• Cardiac Catheters
• Catheter Ablation
• Disease-Free Survival
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Survival Rate