Long-term outcome after successful catheter ablation of atrial fibrillation

Wendy S. Tzou, Francis E. Marchlinski, Erica S. Zado, David Lin, Sanjay Dixit, David J. Callans, Joshua M. Cooper, Rupa Bala, Fermin Garcia, Mathew D. Hutchinson, Michael P. Riley, Ralph Verdino, Edward P. Gerstenfeld

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171 Scopus citations

Abstract

Background-Pulmonary vein isolation (PVI) is increasingly used for treatment of atrial fibrillation (AF), but few reports exist regarding long-term success. We determined 5-year outcomes of PVI among patients with freedom from AF off antiarrhythmic drugs (AAD) for 1 year after PVI. Methods and Results-Consecutive patients with paroxysmal or persistent AF who underwent PVI at the University of Pennsylvania from 2000 to 2003 and were free from AF 1 year after ablation were included. Proximal isolation of PVs and non-PV triggers of AF was performed. Long-term ablation success, defined as freedom from AF off AAD after a single ablation procedure, was determined. All patients had transtelephonic monitoring at 3 to 6 months and 12 months and at least yearly contact thereafter. One hundred twenty-three patients were free of AF without AAD at 1 year. AF freedom off AAD was 85% at 3 years and 71% at 5 years, with an approximate 7% per year late recurrence rate after the first year. Patients with recurrent AF ≥5 years after index PVI were older, had larger left atrial size, more AF triggers and more likely had persistent AF. In multivariate analysis, persistent AF (odds ratio, 2.8; 95% confidence interval, 1.4 to 5.7, P=0.005) and age (odds ratio, 1.1; 95% confidence interval, 1.0 to 1.1, P=0.036) independently predicted long-term AF recurrence. Conclusions-Among patients with paroxysmal or persistent AF and AF freedom 1 year after segmental PVI, the majority (71%) remained free of AF for up to 5 years, with an approximate late recurrence rate of 7% per year. Continued vigilance for recurrent AF after PV isolation is warranted, particularly in patients with persistent AF.

Original languageEnglish (US)
Pages (from-to)237-242
Number of pages6
JournalCirculation: Arrhythmia and Electrophysiology
Volume3
Issue number3
DOIs
StatePublished - Jun 1 2010

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Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Pulmonary vein isolation outcome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Tzou, W. S., Marchlinski, F. E., Zado, E. S., Lin, D., Dixit, S., Callans, D. J., Cooper, J. M., Bala, R., Garcia, F., Hutchinson, M. D., Riley, M. P., Verdino, R., & Gerstenfeld, E. P. (2010). Long-term outcome after successful catheter ablation of atrial fibrillation. Circulation: Arrhythmia and Electrophysiology, 3(3), 237-242. https://doi.org/10.1161/CIRCEP.109.923771