Preprocedural predictors of atrial fibrillation recurrence following pulmonary vein antrum isolation in patients with paroxysmal atrial fibrillation: long-term follow-up results.
J Cardiovasc Electrophysiol
; 22(6): 621-5, 2011 Jun.
Article
em En
| MEDLINE
| ID: mdl-21235666
ABSTRACT
INTRODUCTION:
The objective of this study was to identify the simple preprocedural parameters of atrial fibrillation (AF) recurrence following single ablation procedure in patients with paroxysmal AF during long-term follow-up period. METHODS ANDRESULTS:
Consecutive 474 patients (61 ± 10 years; 364 males, left atrial (LA) diameter 37.6 ± 5.1 mm) with drug-refractory paroxysmal AF who underwent AF ablation were analyzed. Pulmonary vein antrum isolation (PVAI), cavotricuspid isthmus line creation with bidirectional conduction block, and elimination of all non-PV triggers of AF were performed in all patients. With a mean follow-up of 30 ± 13 months after single procedure, 318 patients (67.1%) were in sinus rhythm without any antiarrhythmic drugs. Multivariate analysis using Cox's proportional hazards model, including the age, gender, duration of AF, body mass index, LA size, left ventricular ejection fraction, and presence of hypertension and structural heart disease as variables, demonstrated that LA size was an independent predictor of AF recurrences after PVAI with a 7.2% increase in the probability for every 1 mm increase in LA diameter (P = 0.0007). When the patients were categorized into 3 groups according to the LA diameter, the patients with moderate (40-50 mm) and severe dilatation (>50 mm) had a 1.30-fold (P = 0.0131) and 2.14-fold (P = 0.0057) increase, respectively, in the probability of recurrent AF as compared with the patients with normal LA diameter (≤40 mm).CONCLUSION:
In the long-term follow-up period, LA size was the best preprocedural predictor of AF recurrence following single ablation procedure in the patients with paroxysmal AF, even in the patients with a relatively small LA.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Veias Pulmonares
/
Fibrilação Atrial
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Cardiovasc Electrophysiol
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
FISIOLOGIA
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Japão