Non-inducibility of atrial fibrillation after bi-directional pulmonary vein isolation predicted freedom from AF at 12 months (OR 3.84, P=0.047).
Cohort (n=102)
Odds Ratio: 3.84
p-value: p=0.047
AIMS: This study evaluates whether non-inducibility of atrial fibrillation (AF) after achieving bi-directional electrical pulmonary vein (PV) isolation is a useful predictor of freedom from AF recurrence. METHODS AND RESULTS: This study included 102 consecutive patients who underwent PV isolation for symptomatic paroxysmal (59%), persistent (32%), or permanent (9%) AF. Patients were followed for 16+/-10 months. Complete isolation of all four PVs was confirmed by demonstration of bi-directional block, defined by both loss of PV potentials and failure to capture the LA by pacing (at 10 mA) 10-14 bipolar pairs of electrodes on a circumferential catheter positioned at the entrance of the PV. Induction of AF by burst pacing on/off isoproterenol was attempted after PV isolation. Freedom from recurrent symptomatic or asymptomatic AF was present in 70% of patients at 6 months and 62% of patients at 12 months. In multi-variable analysis, non-inducibility post-PV isolation (OR=3.84, P=0.047) and paroxysmal AF (OR=4.80, P=0.012) predicted freedom from AF at 12 months. CONCLUSION: Non-inducibility of AF after bi-directional PV isolation predicts maintenance of sinus rhythm. This finding suggests that routine extensive left atrial ablation may be unnecessary.
Essebag et al. (Fri,) conducted a cohort in Atrial fibrillation (n=102). Non-inducibility of AF post-PV isolation vs. Inducibility of AF post-PV isolation was evaluated on Freedom from AF at 12 months (OR 3.84, p=0.047). Non-inducibility of atrial fibrillation after bi-directional pulmonary vein isolation predicted freedom from AF at 12 months (OR 3.84, P=0.047).