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Outcomes of radiofrequency catheter ablation for persistent and long-standing persistent atrial fibrillation

André Azul Freitas1, Pedro A Sousa1, Luís Elvas1

  • 1Cardiology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology
|September 8, 2022
PubMed

Insights

Catheter ablation effectively treats persistent and long-standing persistent atrial fibrillation (AF). A tailored approach showed lower recurrence rates than pulmonary vein isolation plus complex fractionated atrial electrograms ablation.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Persistent and long-standing persistent atrial fibrillation (AF) pose significant treatment challenges.
  • Catheter ablation is a key therapeutic option for managing complex AF.
  • Optimizing ablation strategies is crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate one-year outcomes of catheter ablation in patients with persistent and long-standing persistent AF.
  • To compare the efficacy of two distinct ablation strategies: PVI+CFAE versus a tailored approach.
  • To identify predictors of arrhythmia recurrence after ablation.

Main Methods:

  • Retrospective observational study of 67 patients with persistent or long-standing persistent AF undergoing catheter ablation.
  • Comparison of pulmonary vein isolation (PVI) plus complex fractionated atrial electrograms (CFAE) versus a tailored ablation strategy.
  • Analysis of one-year arrhythmia recurrence rates and secondary endpoints based on AF type and ablation strategy.

Main Results:

  • Overall arrhythmia recurrence at one year was 27%.
  • Long-standing persistent AF showed higher recurrence (44.4%) than persistent AF (15%).
  • The tailored approach demonstrated significantly lower recurrence (17.5%) compared to PVI+CFAE (40.7%).
  • Ablation strategy, time in continuous AF, and left atrial volume index independently predicted recurrence.

Conclusions:

  • Catheter ablation is an effective treatment for persistent and long-standing persistent AF.
  • A tailored ablation approach is associated with lower arrhythmia recurrence.
  • Identifying predictors aids in refining patient selection and procedural planning for AF ablation.
Abstract

Keywords:
Ablação por cateterAbordagem individualizadaCatheter ablationFA persistenteFA persistente de longa duraçãoLong-standing persistent atrial fibrillationPersistent atrial fibrillationTailored approach

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