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Original research article
Long-term outcomes after ablation of persistent atrial fibrillation: an observational study over 6 years
  1. Gareth J Wynn1,2,
  2. Moutaz El-Kadri1,
  3. Iram Haq1,
  4. Moloy Das1,3,
  5. Simon Modi1,
  6. Richard Snowdon1,
  7. Mark Hall1,
  8. Johan EP Waktare1,
  9. Derick M Todd1 and
  10. Dhiraj Gupta1,3
  1. 1Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, Liverpool, UK
  2. 2Royal Melbourne Hospital, Melbourne, Australia
  3. 3National Heart and Lung Institute, Imperial College London, London, UK
  1. Correspondence to Dr Dhiraj Gupta; dhiraj.gupta{at}lhch.nhs.uk

Abstract

Objectives To address the limited long-term outcome data for catheter ablation (CA) of persistent atrial fibrillation (PeAF), we analysed consecutive ablations performed at our centre from 1 January 2008 to 31 December 2010 and followed patients prospectively until January 2014.

Methods Both arrhythmia recurrence and symptom relief were assessed. Follow-up data were collected from hospital records, supplemented by data from general practitioners and referring hospitals. At the end of the follow-up period, all patients were contacted by phone to determine their up-to-date clinical condition.

Results 188 consecutive patients with PeAF (157 male, mean age 57.3±9.7 years, 20% with long-standing PeAF) underwent a mean of 1.75 procedures (range 1–4). Telephone follow-up was achieved for 77% of surviving patients. Over a mean follow-up of 46±16 months (range 4–72), 139 (75%) patients experienced arrhythmia recurrence after a single procedure and 90 (48%) after their final procedure. Median time to first recurrence was 210 days (range 91–1850). 71% of recurrences were within the first year following ablation and 91% within 2 years. At final follow-up, 82% of patients reported symptomatic improvement. 7 (2.3%) major complications occurred, and there was no procedure-related death or stroke.

Conclusions CA for PeAF is safe with a low rate of complications. Over a follow-up period of up to 6 years, a large majority of patients experience significant symptomatic improvement but recurrence after the initial procedure is the norm rather than the exception. 2 years' follow-up is sufficient to observe 90% of AF recurrences, but recurrence can occur even after 5 years' remission.

  • Electrophysiology
  • Cardiac arrhythmias and resuscitation science

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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