Ten-year ablation outcomes of patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation

Wen Han Cheng, Li Wei Lo*, Yenn Jiang Lin, Shih Lin Chang, Yu Feng Hu, Yuan Hung, Fa Po Chung, Jo Nan Liao, Ta Chuan Tuan, Tze Fan Chao, Tseng Ying Tsai, Shin Huei Liu, Shih Ann Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Background: Pulmonary vein isolation (PVI) is commonly performed in patients with drug-refractory symptomatic paroxysmal atrial fibrillation (PAF). However, the very long-term follow-up result is limited. Objective: We aimed to investigate 10-year ablation outcomes in patients with PAF and long-term follow-up results after PVI. Methods: This study retrospectively enrolled 176 (131 men, mean age 51.2 ± 12.1 years) patients with drug-refractory symptomatic PAF who underwent electroanatomic-guided PVI. Ten-year follow-up was completed using medical records or telephonic interviews. Procedural characteristics at index procedures and long-term clinical outcomes were investigated. Results: After a mean follow-up period of 130.0 ± 10.8 months, sinus rhythm was achieved in 102 (58%) patients after a single procedure (including 14 (8%) patients on antiarrhythmic medications) and in 88% patients after multiple procedures (including 17 (10%) patients on antiarrhythmic medications). Left atrial diameter (odds ratio 1.067; 95% confidence interval 1.009–1.127; P = .023) was the predictor of recurrent atrial tachyarrhythmia after a single ablation procedure. The single-procedure recurrence-free rates were similar between circumferential PVI and segmental PVI (59% and 50%; log-rank, P = .251). The recurrence patterns of both groups regarding the role of non–pulmonary vein and pulmonary vein triggers were similar. Conclusion: The single-procedure long-term efficacy was modest, with freedom from atrial fibrillation at 10 years being 58%. Those who had enlarged left atrial diameters have more atrial tachyarrhythmia recurrences. Ten-year single-procedure outcomes of the effects of circumferential PVI and segmental PVI in patients with PAF were similar.

Original languageEnglish
Pages (from-to)1327-1333
Number of pages7
JournalHeart Rhythm
Volume16
Issue number9
DOIs
StatePublished - Sep 2019

Keywords

  • Atrial fibrillation
  • Left atrium
  • Long-term
  • Pulmonary vein isolation
  • Recurrence

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