Left atrial size was the major independent predictor of atrial fibrillation recurrence after a single ablation procedure for persistent AF (HR 1.05/mm; 95% CI 1.02-1.08).
Cohort (n=191)
Left atrial size is a major independent predictor of AF recurrence after ablation for persistent AF, which has important implications for patient selection.
Effect estimate: HR 1.05/mm (95% CI 1.02-1.08)
AIMS: To establish clinical factors affecting success in persistent atrial fibrillation (AF) ablation. METHODS AND RESULTS: Wide area circumferential ablation with linear and electrogram-based left atrial (LA) ablation was performed in 191 consecutive patients for persistent AF. After mean follow-up of 13.0 ± 8.9 months, overall success was 64% requiring a mean of 1.5 procedures. Single procedure success rate was 32%. Left atrial size was a univariate predictor of recurrence after a single procedure (P =0.04). Only LA size hazard ratio (HR) 1.05/mm with 95% confidential interval (CI) 1.02-1.08 was an independent predictor of recurrence after a single procedure. Only LA size was a univariate predictor of recurrence after multiple procedures (P 43 mm, HCM (HR 3.09 with 95% CI 1.70-7.5) and AF duration (HR 1.07/year with 95% CI 1.00-1.13) were independent predictors of recurrence. CONCLUSION: Left atrial size is the major independent determinant of AF recurrence after ablation for persistent AF. This has important implications for patient selection for persistent AF ablation and the evaluation of AF ablation clinical trial results.
McCready et al. (Wed,) conducted a cohort in persistent atrial fibrillation (n=191). Radiofrequency ablation (wide area circumferential ablation with linear and electrogram-based left atrial ablation) was evaluated on recurrence after a single procedure (HR 1.05/mm, 95% CI 1.02-1.08). Left atrial size was the major independent predictor of atrial fibrillation recurrence after a single ablation procedure for persistent AF (HR 1.05/mm; 95% CI 1.02-1.08).