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Clinical Predictors of Termination and Clinical Outcome of Catheter Ablation for Persistent Atrial Fibrillation

Matsuo, Seiichiro; Lellouche, Nicolas; Wright, Matthew; Bevilacqua, Michela; Knecht, Sebastien; Nault, Isabelle; Lim, Kang-Teng; Arantes, Leonardo; O'Neill, Mark D. and Platonov, Pyotr LU , et al. (2009) In Journal of the American College of Cardiology 54(9). p.788-795
Abstract
Objectives This study evaluated the role of pre-procedural clinical variables to predict procedural and clinical outcomes of catheter ablation in patients with long-lasting persistent atrial fibrillation (AF). Background Catheter ablation of persistent AF remains a challenging task. Methods Catheter ablation was performed in 90 patients (76 men, age 57 +/- 11 years) with long-lasting persistent AF. The history of AF, echocardiographic parameters, presence of structural heart disease, and surface electrocardiogram (ECG) AF cycle length (CL) were assessed before ablation and analyzed with respect to procedural termination and clinical outcome. Mean follow-up was 28 +/- 4 months. Results Persistent AF was terminated in 76 of 90 patients (84%)... (More)
Objectives This study evaluated the role of pre-procedural clinical variables to predict procedural and clinical outcomes of catheter ablation in patients with long-lasting persistent atrial fibrillation (AF). Background Catheter ablation of persistent AF remains a challenging task. Methods Catheter ablation was performed in 90 patients (76 men, age 57 +/- 11 years) with long-lasting persistent AF. The history of AF, echocardiographic parameters, presence of structural heart disease, and surface electrocardiogram (ECG) AF cycle length (CL) were assessed before ablation and analyzed with respect to procedural termination and clinical outcome. Mean follow-up was 28 +/- 4 months. Results Persistent AF was terminated in 76 of 90 patients (84%) by ablation. The duration of continuous AF was shorter (p < 0.0001), the surface ECG AFCL was longer (p < 0.0001), and the left atrium was smaller (p < 0.01) in patients in whom AF was terminated by catheter ablation. The surface ECG AFCL was the only independent predictor of AF termination (p < 0.01). Maintenance of sinus rhythm was associated with a shorter duration of continuous AF (p < 0.0001), a longer surface ECG AFCL (p < 0.001), and a smaller left atrium (p < 0.05) compared with those with recurrent arrhythmia. In multivariate analysis, the surface ECG AFCL and the AF duration predicted clinical success of persistent AF ablation (p < 0.01 and p < 0.05, respectively). Conclusions The surface ECG AFCL is a clinically useful pre-ablation tool for predicting patients in whom sinus rhythm can be restored by catheter ablation. The duration of continuous AF and the surface ECG AFCL are predictive of maintenance of sinus rhythm. (J Am Coll Cardiol 2009; 54: 788-95) (C) 2009 by the American College of Cardiology Foundation (Less)
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publication status
published
subject
keywords
atrial fibrillation, catheter ablation, predictor
in
Journal of the American College of Cardiology
volume
54
issue
9
pages
788 - 795
publisher
Elsevier USA
external identifiers
  • wos:000269309800004
  • scopus:68649096151
ISSN
0735-1097
DOI
10.1016/j.jacc.2009.01.081
language
English
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yes
id
2d8463f6-061d-435e-98c9-f4217c83ddce (old id 1476217)
date added to LUP
2009-09-29 13:15:33
date last changed
2017-10-22 03:52:51
@article{2d8463f6-061d-435e-98c9-f4217c83ddce,
  abstract     = {Objectives This study evaluated the role of pre-procedural clinical variables to predict procedural and clinical outcomes of catheter ablation in patients with long-lasting persistent atrial fibrillation (AF). Background Catheter ablation of persistent AF remains a challenging task. Methods Catheter ablation was performed in 90 patients (76 men, age 57 +/- 11 years) with long-lasting persistent AF. The history of AF, echocardiographic parameters, presence of structural heart disease, and surface electrocardiogram (ECG) AF cycle length (CL) were assessed before ablation and analyzed with respect to procedural termination and clinical outcome. Mean follow-up was 28 +/- 4 months. Results Persistent AF was terminated in 76 of 90 patients (84%) by ablation. The duration of continuous AF was shorter (p &lt; 0.0001), the surface ECG AFCL was longer (p &lt; 0.0001), and the left atrium was smaller (p &lt; 0.01) in patients in whom AF was terminated by catheter ablation. The surface ECG AFCL was the only independent predictor of AF termination (p &lt; 0.01). Maintenance of sinus rhythm was associated with a shorter duration of continuous AF (p &lt; 0.0001), a longer surface ECG AFCL (p &lt; 0.001), and a smaller left atrium (p &lt; 0.05) compared with those with recurrent arrhythmia. In multivariate analysis, the surface ECG AFCL and the AF duration predicted clinical success of persistent AF ablation (p &lt; 0.01 and p &lt; 0.05, respectively). Conclusions The surface ECG AFCL is a clinically useful pre-ablation tool for predicting patients in whom sinus rhythm can be restored by catheter ablation. The duration of continuous AF and the surface ECG AFCL are predictive of maintenance of sinus rhythm. (J Am Coll Cardiol 2009; 54: 788-95) (C) 2009 by the American College of Cardiology Foundation},
  author       = {Matsuo, Seiichiro and Lellouche, Nicolas and Wright, Matthew and Bevilacqua, Michela and Knecht, Sebastien and Nault, Isabelle and Lim, Kang-Teng and Arantes, Leonardo and O'Neill, Mark D. and Platonov, Pyotr and Carlson, Jonas and Sacher, Frederic and Hocini, Meleze and Jais, Pierre and Haissaguerre, Michel},
  issn         = {0735-1097},
  keyword      = {atrial fibrillation,catheter ablation,predictor},
  language     = {eng},
  number       = {9},
  pages        = {788--795},
  publisher    = {Elsevier USA},
  series       = {Journal of the American College of Cardiology},
  title        = {Clinical Predictors of Termination and Clinical Outcome of Catheter Ablation for Persistent Atrial Fibrillation},
  url          = {http://dx.doi.org/10.1016/j.jacc.2009.01.081},
  volume       = {54},
  year         = {2009},
}