Total pulmonary vein isolation achieved freedom from symptomatic AF without antiarrhythmic drugs in 57% of persistent AF patients compared to 84% of paroxysmal AF patients (p=0.04).
Observational (n=68)
Does total pulmonary vein isolation improve freedom from symptomatic AF in patients with persistent atrial fibrillation compared to paroxysmal atrial fibrillation?
Total pulmonary vein isolation is effective for both paroxysmal and persistent AF, though single-procedure success without antiarrhythmic drugs is higher in paroxysmal AF.
Tasa de eventos absoluta: 57% vs 84%
valor p: p=0.04
Background: Although the efficacy of pulmonary vein (PV) isolation for paroxysmal atrial fibrillation (AF) has been well‐established, its effect on persistent AF has not been sufficiently established to date. Methods and Results: In 68 consecutive patients (mean age, 52 ± 10 years) with paroxysmal (45) and persistent (23) AF, isolation of all four PVs was performed and the subsequent clinical outcome was evaluated. In total, 268/272 PVs (99%) were completely isolated from the left atrium by radiofrequency applications. During a mean follow‐up period of 11 months, 84% of patients with paroxysmal AF and 57% of patients with persistent AF were free from symptomatic AF without any antiarrhythmic drug (AAD) therapy (p = 0.04). In the remaining recurrent AF patients, no significant difference between the paroxysmal and persistent AF was observed as long as they took AADs which had been ineffective at baseline (freedom from AF; 98% and 96%, respectively, p = NS). Repeat procedure performed in the 12 recurrent patients (paroxysmal AF 6, persistent AF 6) allowed 11 (92%) of them to become free from AF recurrence without AADs. Conclusion: Electrical isolation of PV by standard catheter technique is equally and highly effective for both paroxysmal and persistent AF patients, when all four PVs were isolated.
Matsuo et al. (Mon,) conducted a observational in Paroxysmal and persistent atrial fibrillation (n=68). Total pulmonary vein isolation vs. Paroxysmal AF group was evaluated on Freedom from symptomatic AF without any antiarrhythmic drug (AAD) therapy (p=0.04). Total pulmonary vein isolation achieved freedom from symptomatic AF without antiarrhythmic drugs in 57% of persistent AF patients compared to 84% of paroxysmal AF patients (p=0.04).
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