Author + information
- Received January 9, 2009
- Revision received May 17, 2010
- Accepted May 28, 2010
- Published online January 11, 2011.
- Rukshen Weerasooriya, BMedSc(Hons), MBBS⁎,†,⁎ (, )
- Paul Khairy, MD, PhD‡,
- Jean Litalien, MD⁎,
- Laurent Macle, MD‡,
- Meleze Hocini, MD⁎,
- Frederic Sacher, MD⁎,
- Nicolas Lellouche, MD⁎,
- Sebastien Knecht, MD⁎,
- Matthew Wright, PhD, MD⁎,
- Isabelle Nault, MD⁎,
- Shinsuke Miyazaki, MD⁎,
- Christophe Scavee, MD⁎,
- Jacques Clementy, MD⁎,
- Michel Haissaguerre, MD⁎ and
- Pierre Jais, MD⁎
- ↵⁎Reprint requests and correspondence:
Dr. Rukshen Weerasooriya, Hôpital Cardiologique du Haut-Lévêque, 33604 Bordeaux-Pessac, France
Objectives This study describes 5-year follow-up results of catheter ablation for atrial fibrillation (AF).
Background Long-term efficacy following catheter ablation of AF remains unknown.
Methods A total of 100 patients (86 men, 14 women), age 55.7 ± 9.6 years, referred to our center for a first AF ablation (63% paroxysmal; 3.5 ± 1.4 prior ineffective antiarrhythmic agents) were followed for 5 years. Complete success was defined as absence of any AF or atrial tachycardia recurrence (clinical or by 24-h Holter monitoring) lasting ≥30 s.
Results Arrhythmia-free survival rates after a single catheter ablation procedure were 40%, 37%, and 29% at 1, 2, and 5 years, respectively, with most recurrences over the first 6 months. Patients with long-standing persistent AF experienced a higher recurrence rate than those with paroxysmal or persistent forms (hazard ratio [HR]: 1.9, 95% confidence interval [CI]: 1.0 to 3.5; p = 0.0462). In all, 175 procedures were performed, with a median of 2 per patient. Arrhythmia-free survival following the last catheter ablation procedure was 87%, 81%, and 63% at 1, 2, and 5 years, respectively. Valvular heart disease (HR: 6.0, 95% CI: 2.0 to 17.6; p = 0.0012) and nonischemic dilated cardiomyopathy (HR: 34.0, 95% CI: 6.3 to 182.1; p < 0.0001) independently predicted recurrences. Major complications (cardiac tamponade requiring drainage) occurred in 3 patients (3%).
Conclusions In selected patients with AF, a catheter ablation strategy with repeat intervention as necessary provides acceptable long-term relief. Although most recurrences transpire over the first 6 to 12 months, a slow but steady decline in arrhythmia-free survival is noted thereafter.
Dr. Macle has received research grant support from Biosense-Webster and St. Jude Medical, and honoraria from Biosense-Webster, Sanofi-Aventis, and St. Jude Medical. Dr. Hocini has received speaker fees from Biosense and Bard. Dr. Nault has received fellowship support from St. Jude Medical. All other authors have reported that they have no relationships to disclose. Oussama M. Wazni, MD, served as Guest Editor for this paper.
- Received January 9, 2009.
- Revision received May 17, 2010.
- Accepted May 28, 2010.
- American College of Cardiology Foundation