Europace Advance Access originally published online on February 19, 2008
Europace 2008 10(4):419-424; doi:10.1093/europace/eun018
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'ABLATE AND PACE': STILL A VALID TREATMENT FOR AF
Long-term follow-up after radiofrequency catheter ablation for atrial fibrillation
1 Department of Cardiology, Athens Euroclinic, 9 Athanassiadou Street, Athens 11521, Greece; 2 Division of Cardiology, Virginia Commonwealth University School of Medicine and the Medical College of Virginia Hospital, Richmond, VA, USA
Aims: Data on long-term follow-up of patients who have undergone catheter ablation for atrial fibrillation (AF) are very limited. This report aimed at presenting clinical outcome and AF-free survival after pulmonary vein (PV) isolation over an extended (>3 years) follow-up period.
Methods and results: Thirty-nine patients subjected to PV isolation for paroxysmal AF were followed-up for at least 3 years according to a strict protocol. Fourteen patients (35.8%) had one, 19 patients (50%) had two, and 6 patients (15.4%) had three ablation procedures. At end of follow-up (42.2 ± 6.0 months), 17 patients (43.5%) were completely free of AF or other atrial arrhythmia, and 26 patients (66.6%) had symptomatic improvement. The long-term success rate was 21.4% for patients subjected to a single ablation procedure, 52.6% for patients subjected to two catheter ablation procedures, and 66.7% for patients who underwent three ablation procedures (P = 0.094). There was also a trend for patients who underwent a combination of different ablation procedures (ostial, antral, and/or circumferential) to have a higher AF-free survival when compared with patients subjected to the same procedure (P-value for log-rank test = 0.036).
Conclusion: Catheter ablation does not eliminate paroxysmal AF in up to 56% of patients in the long term, despite the use of two or three ablation procedures in two-thirds of them. However, it confers symptomatic improvement in 67% of treated patients.
Key Words: Atrial fibrillation, Ablation, Long-term follow-up
* Corresponding author. Tel: +30 210 6416600; fax: +30 210 6416661. E-mail address: dkatritsis{at}euroclinic.gr
Manuscript submitted 22 November 2007. Accepted after revision 9 January 2008.
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  C. Martignani, I. Diemberger, M. Biffi, C. Valzania, M. Bertini, and G. Boriani How to assess the efficacy of catheter ablation of atrial fibrillation? Eur. Heart J., September 1, 2008; 29(17): 2183 - 2184. [Full Text] [PDF]
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