Catheter Ablation for Atrial Fibrillation Are Results Maintained at 5 Years of Follow-Up?

被引：576

作者：

Weerasooriya, Rukshen ^{[1
,2
]}

Khairy, Paul ^{[3
]}

Litalien, Jean ^{[1
]}

Macle, Laurent ^{[3
]}

Hocini, Meleze ^{[1
]}

Sacher, Frederic ^{[1
]}

Lellouche, Nicolas ^{[1
]}

Knecht, Sebastien ^{[1
]}

Wright, Matthew ^{[1
]}

Nault, Isabelle ^{[1
]}

Miyazaki, Shinsuke ^{[1
]}

Scavee, Christophe ^{[1
]}

Clementy, Jacques ^{[1
]}

Haissaguerre, Michel ^{[1
]}

Jais, Pierre ^{[1
]}

机构：

[1] Hop Cardiol Haut Leveque, F-33604 Bordeaux, France

[2] Univ Western Australia, Dept Med, Crawley, WA, Australia

[3] Montreal Heart Inst, Montreal, PQ H1T 1C8, Canada

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2011年 / 57卷 / 02期

关键词：

ablation; atrial fibrillation; follow-up; PULMONARY VEIN ISOLATION; LATE RECURRENCE; RISK;

D O I：

10.1016/j.jacc.2010.05.061

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives This study describes 5-year follow-up results of catheter ablation for atrial fibrillation (AF). Background Long-term efficacy following catheter ablation of AF remains unknown. Methods A total of 100 patients (86 men, 14 women), age 55.7 +/- 9.6 years, referred to our center for a first AF ablation (63% paroxysmal; 3.5 +/- 1.4 prior ineffective antiarrhythmic agents) were followed for 5 years. Complete success was defined as absence of any AF or atrial tachycardia recurrence (clinical or by 24-h Holter monitoring) lasting >= 30 s. Results Arrhythmia-free survival rates after a single catheter ablation procedure were 40%, 37%, and 29% at 1, 2, and 5 years, respectively, with most recurrences over the first 6 months. Patients with long-standing persistent AF experienced a higher recurrence rate than those with paroxysmal or persistent forms (hazard ratio [HR]: 1.9, 95% confidence interval [CI]: 1.0 to 3.5; p = 0.0462). In all, 175 procedures were performed, with a median of 2 per patient. Arrhythmia-free survival following the last catheter ablation procedure was 87%, 81%, and 63% at 1, 2, and 5 years, respectively. Valvular heart disease (HR: 6.0, 95% CI: 2.0 to 17.6; p = 0.0012) and nonischemic dilated cardiomyopathy (HR: 34.0, 95% CI: 6.3 to 182.1; p < 0.0001) independently predicted recurrences. Major complications (cardiac tamponade requiring drainage) occurred in 3 patients (3%). Conclusions In selected patients with AF, a catheter ablation strategy with repeat intervention as necessary provides acceptable long-term relief. Although most recurrences transpire over the first 6 to 12 months, a slow but steady decline in arrhythmia-free survival is noted thereafter. (J Am Coll Cardiol 2011;57:160-6) (C) 2011 by the American College of Cardiology Foundation

引用

页码：160 / 166

页数：7