Predictors of recurrence following radiofrequency ablation for persistent atrial fibrillation.
Europace
; 13(3): 355-61, 2011 Mar.
Article
en En
| MEDLINE
| ID: mdl-21148171
ABSTRACT
AIMS:
To establish clinical factors affecting success in persistent atrial fibrillation (AF) ablation. METHODS ANDRESULTS:
Wide area circumferential ablation with linear and electrogram-based left atrial (LA) ablation was performed in 191 consecutive patients for persistent AF. After mean follow-up of 13.0 ± 8.9 months, overall success was 64% requiring a mean of 1.5 procedures. Single procedure success rate was 32%. Left atrial size was a univariate predictor of recurrence after a single procedure (P =0.04). Only LA size [hazard ratio (HR) 1.05/mm with 95% confidential interval (CI) 1.02-1.08] was an independent predictor of recurrence after a single procedure. Only LA size was a univariate predictor of recurrence after multiple procedures (P < 0.01). Left atrial size (HR 1.07/mm with 95% CI 1.02-1.11) and hypertrophic cardiomyopathy (HCM; HR 2.42 with 95% CI 1.06-5.55) were independent predictors of recurrence after multiple procedures. Ablation strategy did not affect success after a single procedure. Left atrial size of <43 mm predicted long-term success with a sensitivity of 92%, specificity 52%, positive predictive value 49%, and negative predictive value 93%. With LA size >43 mm, HCM (HR 3.09 with 95% CI 1.70-7.5) and AF duration (HR 1.07/year with 95% CI 1.00-1.13) were independent predictors of recurrence.CONCLUSION:
Left atrial size is the major independent determinant of AF recurrence after ablation for persistent AF. This has important implications for patient selection for persistent AF ablation and the evaluation of AF ablation clinical trial results.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Fibrilación Atrial
/
Ablación por Catéter
/
Atrios Cardíacos
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Europace
Asunto de la revista:
CARDIOLOGIA
/
FISIOLOGIA
Año:
2011
Tipo del documento:
Article
País de afiliación:
Reino Unido