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Catheter Ablation for “Lone” Atrial Fibrillation: Efficacy and Predictors of Recurrence
Author(s) -
BUIATTI A.,
KAESS B.,
REENTS T.,
SEMMLER V.,
TELISHVESKA M.,
BOURIER F.,
KORNMAYER M.,
KOTTMAIER M.,
HESSLING G.,
DEISENHOFER I.
Publication year - 2016
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12936
Subject(s) - medicine , atrial fibrillation , catheter ablation , clinical endpoint , cardiology , atrial tachycardia , ablation , tachycardia , atrioventricular block , randomized controlled trial
Catheter Ablation for “Lone” Atrial Fibrillation Background Atrial fibrillation in otherwise healthy young patients has been termed “lone” atrial fibrillation (AF). The best treatment choice is still under discussion. The aim of this study was to report on efficacy and safety of catheter ablation. Methods Among 855 patients referred to our center between 2011 and 2013, 76 (9%) met the diagnostic criteria for lone AF (mean age 45 ± 8 years; mean LA diameter 37 ± 4 mm; paroxysmal AF 82%; persistent AF 18%). The primary endpoint was freedom from any atrial tachycardia after the first ablation; the secondary endpoint was freedom from any atrial tachycardia after the last ablation procedure without antiarrhythmic drugs. Results The primary endpoint occurred in 56 patients (74%) after a mean follow‐up time of 444 ± 344 days. The secondary endpoint occurred in 73 patients (96%) after a mean of 1.3 ablations/patient during a follow‐up time of 459 ± 366 days. The risk of AF recurrence was not influenced by AF duration or by the type of AF (paroxysmal versus persistent). In a multivariate regression analysis smoking (P = 0.001), first degree atrioventricular block (P = 0.001), and early (< 3 months) AF recurrence (P = 0.001) were independently associated with a higher risk of AF recurrence. Major peri‐procedural adverse events did not occur. Conclusions Catheter ablation in young healthy patients is highly effective and safe. The outcomes are maintained during long‐term follow‐up irrespective of preoperative AF duration. Patients with AF recurrence were more likely to smoke, have first degree AV block and early AF recurrence.