Does procedural termination during catheter ablation improve long-term freedom from AF in patients with chronic AF, and how does left atrial size affect this relationship?
Procedural termination of chronic AF during ablation predicts long-term sinus rhythm maintenance primarily in patients with a left atrial diameter <45 mm.
BACKGROUND: The left atrial (LA) size is an important predictor of atrial fibrillation (AF) procedural termination and the long-term outcome. We sought to evaluate the long-term outcome in regard to the LA size and procedural termination. METHODS: Eighty-seven consecutive chronic AF patients (72 males, 53 +/- 10 years) underwent 3D mapping (NavX) and ablation. A stepwise approach including circumferential pulmonary vein (PV) isolation, linear ablation, and continuous complex-fractionated electrogram (CFE) ablation (targeting fractionation intervals of or= 45 mm (n = 38), whether AF procedural termination occurred or not (P = 0.658). CONCLUSIONS: AF procedural termination was related to the long-term success during chronic AF ablation, especially in those with an LA diameter of less than 45 mm. The favorable effect of termination decreased when the LA diameter was >or= 45 mm.
LO et al. (Mon,) studied this question.