B-PO05-097 TEN-YEAR OUTCOMES OF THE PATIENTS WITH NON-PAROXYSMAL ATRIAL FIBRILLATION UNDERGOING CATHETER ABLATION

Abstract

Catheter ablation in patients with non-paroxysmal atrial fibrillation (AF) has become common practice. However, very long-term follow-up result is limited. We aimed to investigate the 10-year catheter ablation outcomes in patients with non-paroxysmal AF. We retrospectively enrolled 100 patients (89 men, mean age 53.5±8.4years) with drug-refractory symptomatic persistent and long-lasting persistent AF who underwent 3D electroanatomic-guided catheter ablation. Procedural characteristics and very long-term outcomes were investigated. In the index procedures, all patients received pulmonary vein isolation, 56, 48, and 32 patients received additional linear, complex fractionated atrial electrogram (CFAE) and non-pulmonary vein (NPV) foci ablations, respectively. After a mean follow-up period of 124.1± 31.7months, single procedure AF free outcome was achieved in 16(16%) patients (3 with antiarrhythmic medications, AAD) and multiple (2.1±1.3) procedures in 53(53.0%) patients. Left atrial (LA) diameter (OR 1.061; 95% CI 1.020 to 1.103; P =0.003), presence of NPV trigger (OR 1.634; 95% CI 1.019 to 2.623; P =0.042) and receiving CFAE ablation (OR 2.003; 95% CI 1.262 to 3.180 ; P =0.003) in the index procedure are independent predictors for recurrent atrial tachyarrhythmia. The very long-term single ablation outcome of non-paroxysmal AF is unsatisfactory, with freedom from recurrence at 10 years of 16%. Enlarged LA, presence of NPV triggers, and receiving CFAE ablation in the index procedure independently predict recurrence. Multiple (at least 2) procedures are required to achieve adequate, very long-term rhythm control.