In paroxysmal AF, more than 40% had recurrence 10 years after pulmonary vein isolation
More than 40% of patients with paroxysmal atrial fibrillation had recurrence within 10 years after single-procedure pulmonary vein isolation, according findings published in HeartRhythm.
Wen-Han Cheng, MD, and colleagues investigated 10-year outcomes in patients with paroxysmal AF who underwent pulmonary vein isolation.
“Atrial fibrillation is the most common arrhythmia with marked morbidity, mortality and socioeconomic burden,” Cheng, of the department of medicine at Taipei Veterans General Hospital in Taiwan, and colleagues wrote. “Data of long-term outcomes in patients receiving [pulmonary vein isolation] ... have not yet been evaluated.”
The researchers analyzed 176 retrospectively enrolled patients with drug-refractory symptomatic paroxysmal AF who underwent electroanatomical-guided pulmonary vein isolation (mean age, 51 years; 131 men). Ten-year follow-up was completed through medical records or telephone interviews.
According to the researchers, sinus rhythm was achieved in 58% of patients after a single procedure, 8% of whom were on antiarrhythmic medications, and in 88% of patients after multiple procedures, 10% of whom were on antiarrhythmic medications.
Left atrium diameter (OR = 1.067; 95% CI, 1.009-1.127) was a predictor of atrial tachyarrhythmia after one ablation procedure, with those who had enlarged left atrial diameters having more atrial tachyarrhythmia recurrences.
Single-procedure recurrence rates in circumferential pulmonary vein isolation were similar compared with segmental pulmonary vein isolation (59% vs. 50%, respectively; log-rank P = .251), Cheng and colleagues wrote.
There was no difference in recurrence patterns, including triggers, for both groups.
Comprehensive and meticulous scrutiny on triggers and breakthroughs and careful patient selection can lead to better long-term ablation outcomes, Cheng and colleagues wrote.
“[Pulmonary vein isolation] remains a crucial strategy for catheter ablation in drug-refractory symptomatic [paroxysmal] AF patients,” the researchers wrote. – by Earl Holland Jr.
Disclosures: The authors report no relevant financial disclosures.