What does this research mean for the field?

Radiofrequency catheter ablation maintains sinus rhythm in approximately 70% of patients with paroxysmal atrial fibrillation over a 3-year period, with late recurrence significantly associated with factors including left atrial diameter, pulmonary vein variations, and early recurrence. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

February 26, 2019Journal of International Medical ResearchOpen Access

Radiofrequency catheter ablation for paroxysmal atrial fibrillation: outcomes during a 3-year follow-up period

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Why the study?

The study was conducted to observe the effect of RFCA in patients with PAF and explore risk factors for late recurrence of AF after a single RFCA session.

What is the long-term efficacy of radiofrequency catheter ablation in maintaining sinus rhythm, and what are the risk factors for late recurrence in patients with paroxysmal atrial fibrillation?

Structured PICO

What is the long-term efficacy of radiofrequency catheter ablation in maintaining sinus rhythm, and what are the risk factors for late recurrence in patients with paroxysmal atrial fibrillation?

Population

243 patients with paroxysmal atrial fibrillation (PAF)

Intervention

Radiofrequency catheter ablation (RFCA)

Outcome

Maintenance of sinus rhythm (SR) and late recurrence of atrial fibrillation (LRAF)

Radiofrequency catheter ablation provides durable maintenance of sinus rhythm in the majority of patients with paroxysmal atrial fibrillation over a 3-year follow-up, with left atrial diameter and other anatomical factors predicting late recurrence.

Implication

Supports long-term sinus rhythm maintenance after ablation in paroxysmal AF; leaves open need for randomized confirmation of predictors.

Abstract

OBJECTIVE: This study was performed to observe the effect of radiofrequency catheter ablation (RFCA) in patients with paroxysmal atrial fibrillation (PAF) and to explore the risk factors for late recurrence of atrial fibrillation (LRAF) after a single RFCA session. METHODS: In this retrospective study, 243 patients with PAF underwent RFCA and were followed up regularly. RESULTS: At a median follow-up of 37 months after a single procedure, 60.5% of patients maintained sinus rhythm (SR), and at a median follow-up of 42 months after multiple procedures, 74.9% of patients maintained SR. The statistically significant risk factors for LRAF after a single RFCA session were the left atrial diameter (LAD), left inferior pulmonary vein superior-inferior diameter (LIPV SID), PV number variation, circumferential pulmonary vein isolation (CPVI) combined with additional ablation, and early recurrence of atrial fibrillation (ERAF). The best cut-off value for LAD was 35.5 mm. CONCLUSIONS: During a 3-year follow-up, about 70% of the patients with PAF maintained SR. LRAF after a single procedure was associated with the LAD, LIPV SID, PV number variation, CPVI combined with additional ablation, and ERAF.