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Clinical characteristics of patients with persistent atrial fibrillation successfully treated by left atrial ablation

Yoshihide Takahashi1, Atsushi Takahashi, Taishi Kuwahara

  • 1Yokosuka Kyousai Hospital, Yokosuka, Japan. yoshihide_takahashi@oboe.ocn.ne.jp

Circulation. Arrhythmia and Electrophysiology
|August 10, 2010
PubMed

Insights

Shorter duration of persistent atrial fibrillation (AF) predicts successful left atrial (LA) ablation. Additional right atrial ablation can improve outcomes for patients with refractory AF.

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Persistent atrial fibrillation (AF) presents a significant clinical challenge.
  • Left atrial (LA) ablation is a key therapeutic strategy for AF management.

Purpose of the Study:

  • To characterize patients with persistent AF treated by LA ablation.
  • To identify predictors of successful AF ablation outcomes.

Main Methods:

  • Study included 93 patients undergoing ablation for persistent AF.
  • Procedures involved pulmonary vein isolation, linear ablation, and electrogram-based ablation in the LA and coronary sinus.
  • Follow-up assessed freedom from tachyarrhythmias, atrial tachycardia, and AF recurrence.

Main Results:

  • 38% of patients were free from tachyarrhythmias after the first procedure.
  • Shorter duration of persistent AF and successful termination of AF during ablation predicted better outcomes.
  • In multivariate analysis, AF duration was the sole predictor of freedom from AF (OR 0.80).
  • Repeat ablation in the right atrium for recurrent AF yielded success in 62% of patients.
  • Overall, 82% achieved freedom from tachyarrhythmias at 2 years after a median of 2 procedures.

Conclusions:

  • Shorter persistent AF duration is associated with higher success rates for LA ablation.
  • Right atrial ablation offers incremental benefit for patients with persistent AF refractory to LA-targeted ablation.
Abstract

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