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January 1, 2014International Heart Journal32 citationsOpen Access

The Difference of Predictors for Recurrence After Catheter Ablation of Non-Paroxysmal Atrial Fibrillation According to Follow-Up Period

MKMi‐Na KimJLJae Joong LeeSKSu-A Kim

Key Result

Impaired left atrial emptying fraction (≤ 20%) was the only independent predictor of atrial fibrillation recurrence at 2 years after radiofrequency catheter ablation (OR 2.81, P=0.012).

Study Design

Type

Cohort (n=130)

Structured PICO

P
Population
130 patients with non-valvular persistent (non-paroxysmal) atrial fibrillation, mean age 54.6 years, 87.6% male, in Korea. Exclusions: significant valvular heart disease, hypertrophic cardiomyopathy, congenital heart disease, or previous AF ablation.
I
Intervention
Radiofrequency catheter ablation (RFCA) including isolation of 4 pulmonary veins, with complex fractionated atrial electrogram (CFAE)-guided ablation performed in 64% of patients.
O
Outcome
Recurrence of atrial fibrillation (defined as atrial tachycardia lasting >30 seconds detected by ECG or 24-hour Holter) at 6 months, 1 year, and 2 years after ablation.

Impaired left atrial emptying fraction is a strong, independent predictor of long-term atrial fibrillation recurrence after radiofrequency catheter ablation in patients with persistent AF.

Main Result

Effect estimate: OR 2.81

p-value: p=0.012

Limitations

  • Small sample size
  • Non-random selection of patients for ablation
  • Potential ethnic differences in left atrial size (Asian vs Caucasian)

Abstract

The aim of this study was to assess the clinical and echocardiographic predictors for the recurrence of persistent atrial fibrillation (AF) after ablation during a long-term period.A total of 130 patients with persistent AF who had undergone radiofrequency catheter ablation (RFCA) were enrolled. We analyzed the relation between clinical parameters, echocardiographic parameters, and AF recurrences at 6 months, 1 year, and 2 years after ablation.During the 2-year follow-up, AF recurred in 61 patients (46.6%). In the 6 month follow-up, AF recurrence was associated only with total ablation time only. However, during the 1-year and 2-year follow-up periods, the presence of hypertension, impaired left atrial (LA) emptying fraction (eF) (≤ 20%), decreased LA appendage (LAA) emptying velocity (≤ 20 cm/sec), and LAAeF (≤ 20%) were correlated with AF recurrence (odds ratio OR = 1.87, 2.45, 1.93, and 2.15 respectively, P = 0.016, 0.004, 0.029, and 0.004 respectively). Among these factors, impaired LAeF was the only independent predictor of AF recurrence in multivariate analysis (OR = 2.81, P = 0.012).In patients with persistent AF who had undergone RFCA, the best predictor of AF recurrence after ablation varied according to the follow-up period. Diminished LA function was the only predictor of recurrence in the 2-year follow-up. Pre-procedural assessment of LA function might be helpful in selecting those patients who would benefit from RFCA.

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Cite This Study

Kim et al. (2014) conducted a cohort in Persistent atrial fibrillation (n=130). Impaired left atrial emptying fraction (≤ 20%) was evaluated on Atrial fibrillation recurrence (OR 2.81, p=0.012). Impaired left atrial emptying fraction (≤ 20%) was the only independent predictor of atrial fibrillation recurrence at 2 years after radiofrequency catheter ablation (OR 2.81, P=0.012).

synapsesocial.com/papers/6a161bd0b15b67996719662dhttps://doi.org/10.1536/ihj.13-370
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