10-Year Outcomes of Patients With Non-Paroxysmal Atrial Fibrillation Undergoing Catheter Ablation

Tsung Ying Tsai, Li Wei Lo, Wen Han Cheng, Shin Huei Liu, Yenn Jiang Lin, Shih Lin Chang, Yu Feng Hu, Fa Po Chung, Jo Nan Liao, Ta Chuan Tuan, Tze Fan Chao, Chin Yu Lin, Ting Yung Chang, Chih Min Liu, Chhay Chheng, Dony Yugo Hermanto, Ton Nukhank An, Ahmed Moustafa Moustafa Elimam, Ting Chun Huang, Po Tseng LeeCheng Hung Lee, Shih Ann Chen

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Radiofrequency catheter ablation (RFCA) is commonly performed in patients with non-paroxysmal atrial fibrillation (AF), but because very long-term follow-up results of RFCA are limited, we investigated the 10-year RFCA outcomes of non-paroxysmal AF. Methods and Results: We retrospectively enrolled 100 patients (89 men, mean age 53.5±8.4years) with drug-refractory symptomatic non-paroxysmal AF who underwent 3D electroanatomic-guided RFCA. Procedural characteristics at index procedures and clinical outcomes were investigated. In the index procedures, all patients had pulmonary vein isolation, 56 (56.0%), 48 (48.0%), and 32 (32.0%) underwent additional linear, complex fractionated atrial electrogram (CFAE) and non-pulmonary vein (NPV) foci ablations, respectively. After 124.1±31.7 months, 16 (16%) patients remained in sinus rhythm after just 1 procedure (3 with antiarrhythmic drugs [AAD]) and after multiple (2.1±1.3) procedures in 53 (53.0%) patients (22 with AAD). Left atrial (LA) diameter (hazard ratio HR 1.061; 95% confidence interval (CI) 1.020 to 1.103; P=0.003), presence of NPV triggers (HR 1.634; 95% CI 1.019 to 2.623; P=0.042) and undergoing CFAE ablation (HR 2.003; 95% CI 1.262 to 3.180; P=0.003) in the index procedure were independent predictors for recurrent atrial tachyarrhythmia. Conclusions: The 10-year outcomes of single RFCA in non-paroxysmal AF were unsatisfactory. Enlarged LA, presence of NPV triggers, and undergoing CFAE ablation in the index procedure independently predicted single-procedure recurrence. Multiple procedures are required to achieve adequate rhythm control.

Original languageEnglish
Pages (from-to)84-91
Number of pages8
JournalCirculation Journal
Volume87
Issue number1
DOIs
StatePublished - Jan 2023

Keywords

  • Ablation
  • Atrial fibrillation
  • Left atrium
  • Non-pulmonary vein
  • Outcomes

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