Characteristics and long-term catheter ablation outcome in long-standing persistent atrial fibrillation patients with non-pulmonary vein triggers

Yuan Hung; Li Wei Lo; Yenn Jiang Lin; Shih Lin Chang; Yu Feng Hu; Fa Po Chung; Ta Chuan Tuan; Tze Fan Chao; Jo Nan Liao; Rohit Walia; Abigail Louise D. Te; Shinya Yamada; Chung Hsing Lin; Yao Ting Chang; Chin Yu Lin; Chao Shun Chan; Ying Chieh Liao; Sunu Raharjo; Suresh Allamsetty; Shih Ann Chen

doi:10.1016/j.ijcard.2017.04.050

Characteristics and long-term catheter ablation outcome in long-standing persistent atrial fibrillation patients with non-pulmonary vein triggers

Yuan Hung, Li Wei Lo, Yenn Jiang Lin, Shih Lin Chang, Yu Feng Hu, Fa Po Chung, Ta Chuan Tuan, Tze Fan Chao, Jo Nan Liao, Rohit Walia, Abigail Louise D. Te, Shinya Yamada, Chung Hsing Lin, Yao Ting Chang, Chin Yu Lin, Chao Shun Chan, Ying Chieh Liao, Sunu Raharjo, Suresh Allamsetty, Shih Ann Chen^*

^*Corresponding author for this work

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

37 Scopus citations

Abstract

Background There are limited literatures regarding the non-pulmonary vein (NPV) triggers in long-standing persistent atrial fibrillation (LSPAF). The goal of the present study was to investigate the characteristics and long-term outcome of catheter ablation among these patients. Methods The study included 776 patients (age 53.59 ± 11.38 years-old, 556 males) who received catheter ablation for drug-refractory atrial fibrillation (AF). We divided these patients into 3 groups. Group 1 consisted of 579 patients with paroxysmal AF (PAF), group 2 consisted of 103 patients with persistent AF (PerAF) and group 3 consisted of 94 patients with long-standing persistent AF (LSPAF). The average follow-up duration was 28.53 ± 23.21 months. Results The clinical endpoint was the recurrence of atrial tachyarrhythmia. Among these 3 groups, higher percentages of male (93.6%, P < 0.001), NPV triggers (44.7%, P < 0.001), longer AF duration (6.65 ± 6.72 years, P = 0.029), larger left atrium diameter (44.44 ± 6.79 mm, P < 0.001), and longer procedure time (181.94 ± 70.02 min, P < 0.001) were noted in LSPAF. After the first catheter ablation, the recurrence rate of AF was highest in LSPAF (Log Rank, P < 0.001). Larger left atrium diameters (LAD) (P = 0.006; HR: 1.063; CI: 1.018–1.111) and NPV triggers (P = 0.035; HR: 1.707; 1.037–2.809) independently predicted AF recurrence in LSPAF. Conclusions Compared with PAF and PerAF, LSPAF had a higher incidence of NPV triggers and worse long-term outcome after catheter ablation. NPV triggers and LAD independently predicted AF recurrence after catheter ablation in LSPAF.

Original language	English
Pages (from-to)	205-211
Number of pages	7
Journal	International Journal of Cardiology
Volume	241
DOIs	https://doi.org/10.1016/j.ijcard.2017.04.050
State	Published - 15 Aug 2017

Keywords

Ischemic stroke
Long-standing persistent atrial fibrillation
Outcome
Pulmonary vein

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10.1016/j.ijcard.2017.04.050

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Hung, Y., Lo, L. W., Lin, Y. J., Chang, S. L., Hu, Y. F., Chung, F. P., Tuan, T. C., Chao, T. F., Liao, J. N., Walia, R., Te, A. L. D., Yamada, S., Lin, C. H., Chang, Y. T., Lin, C. Y., Chan, C. S., Liao, Y. C., Raharjo, S., Allamsetty, S., & Chen, S. A. (2017). Characteristics and long-term catheter ablation outcome in long-standing persistent atrial fibrillation patients with non-pulmonary vein triggers. International Journal of Cardiology, 241, 205-211. https://doi.org/10.1016/j.ijcard.2017.04.050

@article{ed896a58ec7d4356bdb8eb5b2491920e,

title = "Characteristics and long-term catheter ablation outcome in long-standing persistent atrial fibrillation patients with non-pulmonary vein triggers",

abstract = "Background There are limited literatures regarding the non-pulmonary vein (NPV) triggers in long-standing persistent atrial fibrillation (LSPAF). The goal of the present study was to investigate the characteristics and long-term outcome of catheter ablation among these patients. Methods The study included 776 patients (age 53.59 ± 11.38 years-old, 556 males) who received catheter ablation for drug-refractory atrial fibrillation (AF). We divided these patients into 3 groups. Group 1 consisted of 579 patients with paroxysmal AF (PAF), group 2 consisted of 103 patients with persistent AF (PerAF) and group 3 consisted of 94 patients with long-standing persistent AF (LSPAF). The average follow-up duration was 28.53 ± 23.21 months. Results The clinical endpoint was the recurrence of atrial tachyarrhythmia. Among these 3 groups, higher percentages of male (93.6%, P < 0.001), NPV triggers (44.7%, P < 0.001), longer AF duration (6.65 ± 6.72 years, P = 0.029), larger left atrium diameter (44.44 ± 6.79 mm, P < 0.001), and longer procedure time (181.94 ± 70.02 min, P < 0.001) were noted in LSPAF. After the first catheter ablation, the recurrence rate of AF was highest in LSPAF (Log Rank, P < 0.001). Larger left atrium diameters (LAD) (P = 0.006; HR: 1.063; CI: 1.018–1.111) and NPV triggers (P = 0.035; HR: 1.707; 1.037–2.809) independently predicted AF recurrence in LSPAF. Conclusions Compared with PAF and PerAF, LSPAF had a higher incidence of NPV triggers and worse long-term outcome after catheter ablation. NPV triggers and LAD independently predicted AF recurrence after catheter ablation in LSPAF.",

keywords = "Ischemic stroke, Long-standing persistent atrial fibrillation, Outcome, Pulmonary vein",

author = "Yuan Hung and Lo, {Li Wei} and Lin, {Yenn Jiang} and Chang, {Shih Lin} and Hu, {Yu Feng} and Chung, {Fa Po} and Tuan, {Ta Chuan} and Chao, {Tze Fan} and Liao, {Jo Nan} and Rohit Walia and Te, {Abigail Louise D.} and Shinya Yamada and Lin, {Chung Hsing} and Chang, {Yao Ting} and Lin, {Chin Yu} and Chan, {Chao Shun} and Liao, {Ying Chieh} and Sunu Raharjo and Suresh Allamsetty and Chen, {Shih Ann}",

note = "Publisher Copyright: {\textcopyright} 2017 Elsevier B.V.",

year = "2017",

month = aug,

day = "15",

doi = "10.1016/j.ijcard.2017.04.050",

language = "English",

volume = "241",

pages = "205--211",

journal = "International Journal of Cardiology",

issn = "0167-5273",

publisher = "Elsevier Ireland Ltd",

}

Hung, Y, Lo, LW, Lin, YJ, Chang, SL , Hu, YF, Chung, FP, Tuan, TC, Chao, TF, Liao, JN, Walia, R, Te, ALD, Yamada, S, Lin, CH, Chang, YT, Lin, CY, Chan, CS, Liao, YC, Raharjo, S, Allamsetty, S & Chen, SA 2017, 'Characteristics and long-term catheter ablation outcome in long-standing persistent atrial fibrillation patients with non-pulmonary vein triggers', International Journal of Cardiology, vol. 241, pp. 205-211. https://doi.org/10.1016/j.ijcard.2017.04.050

TY - JOUR

T1 - Characteristics and long-term catheter ablation outcome in long-standing persistent atrial fibrillation patients with non-pulmonary vein triggers

AU - Hung, Yuan

AU - Lo, Li Wei

AU - Lin, Yenn Jiang

AU - Chang, Shih Lin

AU - Hu, Yu Feng

AU - Chung, Fa Po

AU - Tuan, Ta Chuan

AU - Chao, Tze Fan

AU - Liao, Jo Nan

AU - Walia, Rohit

AU - Te, Abigail Louise D.

AU - Yamada, Shinya

AU - Lin, Chung Hsing

AU - Chang, Yao Ting

AU - Lin, Chin Yu

AU - Chan, Chao Shun

AU - Liao, Ying Chieh

AU - Raharjo, Sunu

AU - Allamsetty, Suresh

AU - Chen, Shih Ann

PY - 2017/8/15

Y1 - 2017/8/15

N2 - Background There are limited literatures regarding the non-pulmonary vein (NPV) triggers in long-standing persistent atrial fibrillation (LSPAF). The goal of the present study was to investigate the characteristics and long-term outcome of catheter ablation among these patients. Methods The study included 776 patients (age 53.59 ± 11.38 years-old, 556 males) who received catheter ablation for drug-refractory atrial fibrillation (AF). We divided these patients into 3 groups. Group 1 consisted of 579 patients with paroxysmal AF (PAF), group 2 consisted of 103 patients with persistent AF (PerAF) and group 3 consisted of 94 patients with long-standing persistent AF (LSPAF). The average follow-up duration was 28.53 ± 23.21 months. Results The clinical endpoint was the recurrence of atrial tachyarrhythmia. Among these 3 groups, higher percentages of male (93.6%, P < 0.001), NPV triggers (44.7%, P < 0.001), longer AF duration (6.65 ± 6.72 years, P = 0.029), larger left atrium diameter (44.44 ± 6.79 mm, P < 0.001), and longer procedure time (181.94 ± 70.02 min, P < 0.001) were noted in LSPAF. After the first catheter ablation, the recurrence rate of AF was highest in LSPAF (Log Rank, P < 0.001). Larger left atrium diameters (LAD) (P = 0.006; HR: 1.063; CI: 1.018–1.111) and NPV triggers (P = 0.035; HR: 1.707; 1.037–2.809) independently predicted AF recurrence in LSPAF. Conclusions Compared with PAF and PerAF, LSPAF had a higher incidence of NPV triggers and worse long-term outcome after catheter ablation. NPV triggers and LAD independently predicted AF recurrence after catheter ablation in LSPAF.

AB - Background There are limited literatures regarding the non-pulmonary vein (NPV) triggers in long-standing persistent atrial fibrillation (LSPAF). The goal of the present study was to investigate the characteristics and long-term outcome of catheter ablation among these patients. Methods The study included 776 patients (age 53.59 ± 11.38 years-old, 556 males) who received catheter ablation for drug-refractory atrial fibrillation (AF). We divided these patients into 3 groups. Group 1 consisted of 579 patients with paroxysmal AF (PAF), group 2 consisted of 103 patients with persistent AF (PerAF) and group 3 consisted of 94 patients with long-standing persistent AF (LSPAF). The average follow-up duration was 28.53 ± 23.21 months. Results The clinical endpoint was the recurrence of atrial tachyarrhythmia. Among these 3 groups, higher percentages of male (93.6%, P < 0.001), NPV triggers (44.7%, P < 0.001), longer AF duration (6.65 ± 6.72 years, P = 0.029), larger left atrium diameter (44.44 ± 6.79 mm, P < 0.001), and longer procedure time (181.94 ± 70.02 min, P < 0.001) were noted in LSPAF. After the first catheter ablation, the recurrence rate of AF was highest in LSPAF (Log Rank, P < 0.001). Larger left atrium diameters (LAD) (P = 0.006; HR: 1.063; CI: 1.018–1.111) and NPV triggers (P = 0.035; HR: 1.707; 1.037–2.809) independently predicted AF recurrence in LSPAF. Conclusions Compared with PAF and PerAF, LSPAF had a higher incidence of NPV triggers and worse long-term outcome after catheter ablation. NPV triggers and LAD independently predicted AF recurrence after catheter ablation in LSPAF.

KW - Ischemic stroke

KW - Long-standing persistent atrial fibrillation

KW - Outcome

KW - Pulmonary vein

UR - http://www.scopus.com/inward/record.url?scp=85018192185&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2017.04.050

DO - 10.1016/j.ijcard.2017.04.050

M3 - Article

C2 - 28456483

AN - SCOPUS:85018192185

SN - 0167-5273

VL - 241

SP - 205

EP - 211

JO - International Journal of Cardiology

JF - International Journal of Cardiology

ER -

Characteristics and long-term catheter ablation outcome in long-standing persistent atrial fibrillation patients with non-pulmonary vein triggers

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Keywords

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