Significance of Late Recurrence of Atrial Fibrillation during Long-Term Follow-Up after Pulmonary Vein Isolation

• Published in: Pacing and clinical electrophysiology 2007-01, Vol.30 (s1), p.S108-S111
• Main Authors: SOLHEIM, EIVIND, HOFF, PER IVAR, OFF, MORTEN KRISTIAN, OHM, OLE-JØRGEN, CHEN, JIAN
• Format: Article
• Language: English
• Subjects: Adult; atrial fibrillation; Atrial Fibrillation - surgery; atrial fibrillation recurrence; Catheter Ablation; Female; Follow-Up Studies; Humans; Male; Middle Aged; pulmonary vein isolation; Pulmonary Veins - innervation; Pulmonary Veins - physiopathology; Pulmonary Veins - surgery; radiofrequency ablation; Recurrence; Treatment Outcome
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/j.1540-8159.2007.00617.x

Background and Study Objective: Patients with paroxysmal or persistent atrial fibrillation (AF) can be treated by pulmonary vein (PV) isolation. Although the recurrence rate after the procedure is relatively high, the long‐term outcomes after initially recurrence‐free procedures remains unclear. We examined the rates of recurrence of AF after PV isolation. Methods: Our study included 278 consecutive patients with drug‐refractory AF (mean age = 53 ± 11 years, 228 men). PV isolation was based on the disappearance of PV potentials recorded from a circumferential catheter after segmental ostium ablation. Cavo‐tricuspid isthmus lines and additional atrial lines were performed in 124 and 28 patients, respectively. Patients were monitored for a mean of 26 ± 11 months (range 12–56). Recurrence was defined as ≥1 episodes of symptomatic or asymptomatic AF >1 month after the procedure. Results: A total of 120 (34) patients had ≥1 recurrence of AF >1 month after the procedure, of whom 14 (4) had a first recurrence >6 months after the procedure. There was a significantly higher recurrence rate among patients with persistent AF. Conclusions: A relatively high AF recurrence rate was observed after PV isolation. AF may recur late after the ablation procedure, though the majority of recurrences occurred within 6 months after the first procedure. There were no differences in incidence or time of occurrence of late recurrences between patients with paroxysmal versus persistent AF.