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Little is known about the long-term outcome and recurrent form recurrence after catheter ablation of atrial fibrillation (AF) in patients with long-standing persistent AF.Two hundred thirty-six patients with persistent AF (193 men; age, 61.5±10.7 years) were enrolled, and were classified according to the duration of AF: AF duration of <1 year (group A, n=99), between 1 to 5 years (group B, n=101), and ≥5 years (group C, n=36). The long-term recurrence rate and recurrent form were compared among the groups.During a median follow-up of 3.7 years, the recurrence rate was significantly worse in group C after the index and multiple procedures (Log-Rank, both for a P<0.001 in comparison to group A). In the multivariate analysis, the duration was an independent predictor of an arrhythmia recurrence (HR, 1.206; 95%CI, 1.053 to 1.381; P=0.007). Recurrent AF became permanent in 8 patients (3.4%), which was not associated with a difference in the groups (Log-rank, P=0.055), while antiarrhythmic drugs (AADs) were continued in 70% of the recurrent patients.Despite a high AF recurrence rate in the patients with an AF duration of ≥5 years, the majority of the patients with recurrence who continued on AADs had a paroxysmal form of AF. Catheter ablation and concomitant AADs may be effective in reducing the AF burden in such patients with an advanced AF disease stage.

journal of atrial fibrillation

Efficacy of Catheter Ablation and Concomitant Antiarrhythmic Drugs on the Reduction of the Arrhythmia Burden in Patients with Long-Standing Persistent Atrial Fibrillation