Clinical Outcome of Very Late Recurrence of Atrial Fibrillation after Catheter Ablation of Paroxysmal Atrial Fibrillation

Hsieh, Ming‐Hsiung; Tai, Ching‐Tai; Tsai, Chin‐Feng; Lin, Wei‐Shiang; Lin, Yung‐Kuo; Tsao, Hsuan‐Ming; Huang, Jin‐Long; Ueng, Kwo-Chang; Yu, Wen‐Chung; Chan, Paul; Ding, Yu‐An; Chang, Mau‐Song; Chen, Shih‐Ann

doi:10.1046/j.1540-8167.2003.03047.x

Cited by 59 publications

(77 citation statements)

References 16 publications

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“…[35][36][37][38] In our study, most late recurrences were due to AF, whereas approximately half of the patients with early recurrence had AFL. We postulate that a significant subset of early recurrence was due to iatrogenic arrhythmia secondary to gaps in ablation lines and/or tissue recovery.…”

Section: Mechanisms Underlying Recurrencesmentioning

confidence: 46%

Natural History and Long-Term Outcomes of Ablated Atrial Fibrillation

Hussein

Saliba

Martin

et al. 2011

Circ: Arrhythmia and Electrophysiology

146

132

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Background-Atrial fibrillation (AF) ablation is increasingly used in clinical practice. We aimed to study the natural history and long-term outcomes of ablated AF. Methods and Results-We followed 831 patients after pulmonary vein isolation (PVI) performed in 2005. We documented clinical outcomes using our prospective AF registry with most recent update on this group of patients in October 2009. In the first year after ablation, 23.8% had early recurrence. Over long-term follow-up (55 months), only 8.9% had late arrhythmia recurrence defined as occurring beyond the first year after ablation. Repeat ablations in patients with late recurrence revealed conduction recovery in at least 1 of the previously isolated PVs in all of them and right-sided triggers with isoproterenol testing in 55.6%. At last follow-up, clinical improvement was 89.9% (79.4% arrhythmia-free off antiarrhythmic drugs and 10.5% with AF controlled with antiarrhythmic drugs). Only 4.6% continued to have drug-resistant AF. It was possible to safely discontinue anticoagulation in a substantial proportion of patients with no recurrence in the year after ablation (CHADS score Յ2, stroke incidence of 0.06% per year). The procedure-related complication rate was very low. Conclusions-Pulmonary vein isolation is safe and efficacious for long-term maintenance of sinus rhythm and control of symptoms in patients with drug-resistant AF. It obviates the need for antiarrhythmic drugs, negative dromotropic agents, and anticoagulants in a substantial proportion of patients. (Circ Arrhythm Electrophysiol. 2011;4:271-278.)

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Section: Mechanisms Underlying Recurrencesmentioning

confidence: 46%

Natural History and Long-Term Outcomes of Ablated Atrial Fibrillation

Hussein

Saliba

Martin

et al. 2011

Circ: Arrhythmia and Electrophysiology

146

132

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“…Heish et al observed that the incidence of VLRAF was 6% 9 and demonstrated that non-PV foci were the essential trigger for VLRAF. 10 Recently, Mainigi et al 11 reported a similar incidence of VLRAF (7.9%) and demonstrated that obese weight was a predictor for VLRAF.…”

Section: Vlraf After Catheter Ablationmentioning

confidence: 99%

Predictors of Very Late Recurrence of Atrial Fibrillation After Circumferential Pulmonary Vein Ablation

Liu

Dong

et al. 2008

Clinical Cardiology

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Background: Early recurrence of atrial fibrillation (ERAF) after catheter ablation is common and has been thoroughly studied. However, very late recurrence of atrial fibrillation (VLRAF) is rarely researched, and its characteristics have not been determined. Hypothesis: The aim of this study was to investigate the clinical characteristics of VLRAF after circumferential pulmonary vein ablation (CPVA), and to identify the risk factors for VLRAF. Methods: We retrospectively studied 259 consecutive patients with atrial fibrillation (AF) who were referred for CPVA. Clinical variables were investigated and predictors of VLRAF were identified. Results: A total of 249 patients were enrolled in this study. After a mean follow-up of 18.2±4.4 mo, 14 patients (5.6%) had VLRAF. Patients with VLRAF were more likely than those without recurrence to have ERAF (78.6% versus 17.8%, p = 0.000) and persistent AF (50.0% versus 13.0%, p = 0.000), but were less likely to achieve pulmonary vein (PV)

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“…The benefits of AF ablation and long term success seem to be dependent on the stage of LA structural remodeling and not on paroxysmal or persistent nature of AF [14]. The reverse remodeling of the LA structure and function after catheter ablation of AF is significantly better when performed in the early stage of arrhythmia with mild LA structural remodeling [14].…”

Section: Resultsmentioning

confidence: 99%

Outcomes and predictors of recurrences after pulmonary vein isolation by cryoballoon or radiofrequency catheter atrial fibrillation ablation

Grecu¹,

Floria²,

Hurjui³

et al. 2017

Arch Clin Cases

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Aim: Catheter-based pulmonary vein isolation (PVI) has become a new option treatment for drug-resistant and symptomatic paroxysmal atrial fibrillation (AF). We aimed to assess the outcomes after radiofrequency and cryoballoon catheter AF ablation. Material and methods: We performed a single-center prospective clinical study enrolling patients who underwent catheter ablation for paroxysmal AF between 2013 and 2015. The main objective was the outcomes after AF ablation by cryoballoon or radiofrequency energy. Follow-up was performed at 3, 6 and 12 months after ablation. Results: A total of 85 patients were included: 64 assigned to radiofrequency and 21 to cryoballoon ablation. Overall success rate at 3, 6 and 12 months post-ablation was 62%, 76% and 75%, respectively. Redo procedure was required in 8 patients (10.3%) at 6 months. Success rate at 12 months was non-significantly higher in radiofrequency ablation group (76% versus 62%; p=0.56). Complication rates were equivalent, without life treating or permanent sequels. Men gender, AF duration, obesity and sleep apnoea syndrome were clinical predictors of AF recurrence at 12 months after procedure. Conclusions: Cryoballoon and radiofrequency ablation appear to be safe and effective procedures for AF treatment, with similar success rate. Men gender, AF duration, obesity and sleep apnea syndrome seem to be associated with AF recurrence after ablation.

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Clinical Outcome of Very Late Recurrence of Atrial Fibrillation after Catheter Ablation of Paroxysmal Atrial Fibrillation

Abstract: The incidence of very late recurrent AF after ablation of paroxysmal AF is very low, and the clinical outcome of patients with very late recurrent AF is benign.

Cited by 59 publications

References 16 publications

Natural History and Long-Term Outcomes of Ablated Atrial Fibrillation

Natural History and Long-Term Outcomes of Ablated Atrial Fibrillation

Predictors of Very Late Recurrence of Atrial Fibrillation After Circumferential Pulmonary Vein Ablation

Outcomes and predictors of recurrences after pulmonary vein isolation by cryoballoon or radiofrequency catheter atrial fibrillation ablation

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