Termination of persistent atrial fibrillation to an organized rhythm during ablation significantly increased sinus rhythm maintenance compared to no termination (82.1% vs 64.3%, P<0.02).
Cohort (n=140)
Does AF termination to AT or SR during catheter ablation reduce late AF recurrence in patients with persistent atrial fibrillation?
Termination of persistent AF to atrial tachycardia or sinus rhythm during ablation of PVAI and low-voltage areas is associated with significantly lower late AF recurrence.
Absolute Event Rate: 82.1% vs 64.3%
p-value: p=<0.02
BACKGROUND: Ablation strategies have been developed to improve outcomes in patients with persistent atrial fibrillation (PsAF). However, the impact of atrial fibrillation (AF) termination on late AF recurrence is not well known. The aim of our study was to evaluate the impact of AF termination to atrial tachycardia (AT) or sinus rhythm (SR) during catheter ablation on late AF recurrence after the 3-month blanking period. METHODS AND RESULTS: We prospectively recruited 140 patients (mean age: 58.5 ± 12.3 years old, 74.3% males) with uninterrupted PsAF of a mean duration of 3.7 months. Pulmonary vein antral isolation (PVAI) was the first ablation step, and if AF did not terminate (to SR or AT), we ablated low-voltage areas less than 0.4 mV with specific electrogram characteristics. We successfully converted AF to AT or SR in 56 patients (40%) during PVAI (n = 24) or low-voltage ablation ( n = 32). The remaining 84 patients (60%) were electrically cardioverted to SR at the end of the procedure. One hundred patients (71.4%) maintained SR after a single procedure during a mean follow-up of 21.1 ± 0.8 months. Of the 56 patients with AF termination, 46 (82.1%) had no recurrence, while in the group of 84 patients without AF termination, 54 patients (64.3%) remained in SR ( P < 0.02). CONCLUSION: Ablation of PVAI and specific electrograms in low-voltage areas less than 0.4 mV can lead to encouraging outcomes with a low recurrence rate as well as a lower need for redo procedures.
Efremidis et al. (Sat,) conducted a cohort in Persistent atrial fibrillation (n=140). AF termination to atrial tachycardia or sinus rhythm during ablation vs. No AF termination (electrical cardioversion to sinus rhythm) was evaluated on Maintenance of sinus rhythm (no AF recurrence) after a 3-month blanking period (p=<0.02). Termination of persistent atrial fibrillation to an organized rhythm during ablation significantly increased sinus rhythm maintenance compared to no termination (82.1% vs 64.3%, P<0.02).
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