Songwen Chen is the cofirst author.
Procedural Arrhythmia Termination and Long-Term Single-Procedure Clinical Outcome in Patients with Non-paroxysmal Atrial Fibrillation
Article first published online: 21 JUN 2013
© 2013 Wiley Periodicals, Inc.
Journal of Cardiovascular Electrophysiology
Volume 24, Issue 10, pages 1092–1100, October 2013
How to Cite
ZHOU, G., CHEN, S., CHEN, G., ZHANG, F., MENG, W., YAN, Y., LU, X., WEI, Y. and LIU, S. (2013), Procedural Arrhythmia Termination and Long-Term Single-Procedure Clinical Outcome in Patients with Non-paroxysmal Atrial Fibrillation. Journal of Cardiovascular Electrophysiology, 24: 1092–1100. doi: 10.1111/jce.12193
This study was supported by the Science and Technology Commission of Shanghai Municipality (No. 10411954800).
- Issue published online: 8 OCT 2013
- Article first published online: 21 JUN 2013
- Accepted manuscript online: 27 MAY 2013 04:14AM EST
- Manuscript Accepted: 21 MAY 2013
- Manuscript Revised: 19 MAY 2013
- Manuscript Received: 4 JAN 2013
- Science and Technology Commission of Shanghai Municipality. Grant Number: 10411954800
- atrial fibrillation;
- atrial tachycardia;
- arrhythmia termination;
- catheter ablation;
- pulmonary vein isolation
Arrhythmia Termination and Long-Term Outcome
The influence of procedural arrhythmia termination on long-term single-procedure clinical outcome in patients with non-paroxysmal atrial fibrillation (AF) remains controversial.
An individualized stepwise ablation strategy was used in 200 consecutive patients with non-paroxysmal AF who underwent first-time radiofrequency catheter ablation, with pulmonary vein isolation and sinus rhythm (SR) restoration as the primary endpoints.
SR was restored by ablation in 94 patients, including 32 with AF directly and 62 with intermediate atrial tachycardia (AT). Cardioversion was performed to restore SR in 106 patients, including 31 with intermediate AT, and 75 with sustained AF. During a mean follow-up of 50.0 ± 9.3 months, single-procedure success was achieved in 99 (49.5%) patients. There was a significant difference in long-term success between patients with SR restoration by ablation and by cardioversion (63.8% vs 36.8%; P < 0.001), but not between patients with AF termination by ablation and by cardioversion (53.6% vs 42.7%; P = 0.146). SR restoration by ablation (odds ratio = 3.032; 95% confidence interval = 1.703–5.398; P < 0.001) was the only predictor of single-procedure success by logistic regression analyses. In patients with intermediate AT (n = 93), AT termination by ablation was associated with a higher success rate than AT termination by cardioversion (62.9% vs 22.6%; P < 0.001).
SR restoration and AT termination by ablation were both associated with an improved long-term single-procedure clinical outcome in patients with non-paroxysmal AF.