Abstract
Background: It is known that additional catheter ablation (CA), including electrogram-based ablation, right isthmus ablation, and so forth, after pulmonary vein isolation (PVI) improve outcome of atrial fibrillation (AF). We investigate the effect of PVI and additional CA for refractory AF patients. Methods: We studied consecutive 33 patients (27 males, 63±11 years, paroxysmal AF 46%, persistent AF 54%) who underwent PVI for AF resistant to combination therapy of Bepridil and Aprindine (Bep+Apr). They were divided into 2 groups, 23 patients with both PVI and additional CA (group A) and 10 patients with PVI alone (group B). We evaluated the relationship between AF recurrence and anti-arrhythmic agents after CA in 2 groups. Results: During 413±435 follow-up days, recurrences of AF in the group B were observed more frequently than those in the group A (70% vs 26%, P=0.02). Moreover, the dosage of both Bepridil and Aprindine in the group A were lower compared with those in the group B (88±51 vs 180±25 mg, P=0.02, 31mg±11 mg vs 44±8 mg, P=0.04, respectively). Conclusions: The present findings suggest that PVI with additional CA improve recurrence rate of refractory AF, leading to reduce the dosage of anti-arrhythmic agents after CA.
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