RT Journal Article
SR Electronic
T1 Long-term outcomes after ablation of persistent atrial fibrillation: an observational study over 6 years
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e000394
DO 10.1136/openhrt-2015-000394
VO 3
IS 2
A1 Gareth J Wynn
A1 Moutaz El-Kadri
A1 Iram Haq
A1 Moloy Das
A1 Simon Modi
A1 Richard Snowdon
A1 Mark Hall
A1 Johan EP Waktare
A1 Derick M Todd
A1 Dhiraj Gupta
YR 2016
UL http://openheart.bmj.com/content/3/2/e000394.abstract
AB 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.