Long-Term Clinical Results of 2 Different Ablation Strategies in Patients With Paroxysmal and Persistent Atrial Fibrillation

被引:153
作者
Gaita, Fiorenzo [1 ]
Caponi, Domenico
Scaglione, Marco
Montefusco, Antonio
Corleto, Antonella
Di Monte, Fernando
Coin, Daniele
Di Donna, Paolo
Giustetto, Carla [2 ]
机构
[1] Univ Turin, Fac Med, Cardinal Massaia Hosp, Div Cardiol, I-14100 Asti, Italy
[2] Univ Turin, Fac Med, Dept Math & Stat, Turin, Italy
关键词
ablation; arrhythmia; atrial fibrillation; catheter ablation; follow-up;
D O I
10.1161/CIRCEP.108.774885
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-Data regarding the long-term efficacy of atrial fibrillation (AF) ablation are still lacking Methods and Results-Two hundred four consecutive patients symptomatic for paroxysmal or persistent/permanent AF were randomly assigned to 2 different ablation schemes: Pulmonary vein isolation (PVI) and PVI plus left linear lesions (LL). Primary end point was to assess the maintenance of sinus rhythm (SR) after procedures 1 and 2 in the absence of antiarrhythmic drugs in a long-term follow-up of at least 3 years. Paroxysmal AF-With a single procedure at 12-month follow-up, 46% of patients treated with PVI maintained SR, whereas at 3-year follow-up, 29% were in SR; using the plus LL" at the 12-month follow-up, 57% of patients were in SR, whereas at the 3-year follow-up, 53% remained in SR. After a second procedure, the long-term overall success rate without antiarrhythmic drugs was 62% with PVI and 85% with PVI plus LL. Persistent/Permanent AF-With a single procedure at the 12-month follow-up, 27% of patients treated with PVI were in SR, whereas at the 3-year follow-up, 19% maintained SR; using the PVI plus LL with a single procedure at the 12-month follow-up 45% of patients were in SR, whereas at the 3-year follow-up, 41% remained in SR. After a second procedure, the long-term overall success rate without antiarrhythmic drugs was 39% with PVI and 75% with PVI plus LL. Conclusions-A long-term follow-up of AF ablation shows that short-term results cannot be considered permanent because AF recurrences are still present after the first year especially in patients who have had "PVI" strategy. PVI isolation plus LL is superior to the PVI strategy in maintaining SR without antiarrhythmic drugs after procedures 1 and 2 both in and persistent AF. (Circ Arrhythmia Electrophysiol. 2008;1:269-275.)
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收藏
页码:269 / 275
页数:7
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