Ablation for symptomatic drug-refractory atrial fibrillation resulted in 73% of patients being AF-free at 12 months, with higher success in paroxysmal (80%) than persistent AF (64%).
Observational (n=129)
Does ablation prevent atrial fibrillation recurrence in patients with symptomatic drug-refractory paroxysmal or persistent atrial fibrillation?
Ablation is highly effective for drug-refractory atrial fibrillation, with higher success rates in paroxysmal versus persistent AF, as confirmed by rigorous 1-year continuous subcutaneous monitoring.
Absolute Event Rate: 80% vs 64%
BACKGROUND: The aim of this prospective observational study was to identify responders to ablation through continuous subcutaneous monitoring for 1 year after ablation in patients with paroxysmal atrial fibrillation (PAF) or persistent AF (PersAF). METHOD: Patients with symptomatic drug refractory AF were enrolled. Real-time three-dimensional (3D) left atrium maps were reconstructed by using a nonfluoroscopic navigation system (CARTO, Biosense-Webster Inc., Diamond Bar, CA, USA). The ipsilateral left and right pulmonary veins (PVs) were encircled in 1 lesion line by circumferential PV isolation. All patients were implanted with Reveal XT (Medtronic Inc.) for continuous AF monitoring and data collected every month during the 12-month follow-up. RESULTS: We enrolled 129 patients (56 ± 9 years, 102 males), all of whom were followed-up for 12 months after the last ablation procedure: 58 (45%) had a history of PersAF. After only 1 ablation procedure, 76 (59%) of the 129 patients were AF-free at 12-month: 48 out of 71 (68%) in the PAF group and 28 out of 58 (48%) in the PersAF group. After 1 or more ablation procedures, 94 (73%) of the 129 patients were AF-free 12 months after the last procedure: 57 out of 71 (80%) in the PAF group and 37 out of 58 (64%) in the PersAF group. CONCLUSION: Ablation is highly effective in treating AF, as assessed through detailed 1-year continuous monitoring: success rate is higher in PAF than in PersAF patients. The use of subcutaneous monitors is a valuable means of identifying responders and nonresponders, and can potentially guide antiarrhythmic and antithrombotic therapies.
Pokushalov et al. (Mon,) conducted a observational in Paroxysmal or persistent atrial fibrillation (n=129). Ablation (Paroxysmal AF group) vs. Ablation (Persistent AF group) was evaluated on AF-free 12 months after the last ablation procedure. Ablation for symptomatic drug-refractory atrial fibrillation resulted in 73% of patients being AF-free at 12 months, with higher success in paroxysmal (80%) than persistent AF (64%).