Radiofrequency catheter ablation guided by electroanatomical mapping achieved a 75.5% recurrence-free rate at 12 months, with increased left atrium size acting as an independent predictor of recurrence (HR 2.58).
Cohort (n=95)
No
Does radiofrequency catheter ablation guided by electroanatomical mapping prevent atrial fibrillation recurrence in patients with refractory symptomatic atrial fibrillation?
Radiofrequency catheter ablation guided by electroanatomical mapping is effective for refractory atrial fibrillation, though increased left atrial size predicts higher recurrence risk.
Effect estimate: HR 2.58 (95% CI 1.26-4.89)
BACKGROUND: Radiofrequency catheter ablation guided by electroanatomical mapping is currently an important therapeutic option for the treatment of atrial fibrillation. The complexity of the procedure, the several techniques used and the diversity of the patients hinder the reproduction of the results and the indication for the procedure. OBJECTIVE: To evaluate the efficacy and factors associated with recurrence of atrial fibrillation. METHODS: Prospective cohort study with consecutive patients submitted to atrial fibrillation ablation treatment guided by electroanatomical mapping. The inclusion criteria were as follows: minimum age of 18 years; presence of paroxysmal, persistent or long-standing persistent AF; AF recording on an electrocardiogram, exercise testing or Holter monitoring (duration longer than 15 minutes); presence of symptoms associated with AF episodes; AF refractoriness to, at least, two antiarrhythmic drugs, one of which being amiodarone, or impossibility to use antiarrhythmic drugs. RESULTS: The study included 95 patients (age 55 ± 12 years, 84% men, mean CHADS2 = 0.8) who underwent 102 procedures with a median follow-up of 13.4 months. The recurrence-free rate after the procedure was 75.5% after 12 months. Atrial fibrillation recurred as follows: 26.9% of patients with paroxysmal and persistent atrial fibrillation; 45.8% of patients with long-standing persistent atrial fibrillation (p = 0.04). Of the analyzed variables, the increased size of the left atrium has proven to be an independent predictor of atrial fibrillation recurrence after the procedure (HR = 2.58; 95% CI: 1.26-4.89). Complications occurred in 4.9% of the procedures. CONCLUSION: Atrial fibrillation ablation guided by electroanatomical mapping has shown good efficacy. The increase in left atrium size was associated with atrial fibrillation recurrence.
Kalil et al. (Tue,) conducted a cohort in Atrial Fibrillation (n=95). Radiofrequency catheter ablation guided by electroanatomical mapping was evaluated on Atrial fibrillation recurrence predicted by increased left atrium size (HR 2.58, 95% CI 1.26-4.89). Radiofrequency catheter ablation guided by electroanatomical mapping achieved a 75.5% recurrence-free rate at 12 months, with increased left atrium size acting as an independent predictor of recurrence (HR 2.58).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: