Abstract
Catheter ablation (CA) for atrial fibrillation (AF) has emerged as a widespread first or second line treatment option. However, up to 45% of patients (pts) show recurrence of AF within 12 month after CA. We present prospective multicenter registry data comparing characteristics of pts with and without recurrence of AF within the first year after CA. This study comprises all pts with complete follow-up one year after CA (1-y-FU; n = 3679). During 1y-FU in 1687 (45.9%) pts recurrence of AF occurred. The multivariate analysis revealed female sex and AF type prior to the procedure as predictors for AF recurrence. Furthermore, comorbidities such as valvular heart disease and renal failure as well as an early AF relapse were also predictors of AF recurrence during 1-y-FU. However, despite an AF recurrence rate of 45.9%, the majority of these pts (72.4%) reported a significant alleviation of clinical symptoms. In conclusion in pts with initially successful CA for AF female sex, AF type, in-hospital AF relapse and comorbidities such as renal failure and valvular heart disease are independent predictors for AF recurrence during 1-y-FU. However, the majority of pts deemed their interventions as successful with significant reduction of symptoms irrespective of AF.
Highlights
Catheter ablation (CA) of atrial fibrillation (AF) has become a safe and well-established treatment option in patients with symptomatic AF1,2
A total of 3703 patients undergoing CA for AF in 40 participating German centers were enrolled in the registry
1 patient died in hospital, due to severe heart failure and 23 during follow up (FU)
Summary
Catheter ablation (CA) of atrial fibrillation (AF) has become a safe and well-established treatment option in patients with symptomatic AF1,2. Within the last decade several studies identified factors such as AF duration, age and AF cycle length, and structural heart disease as predictors for arrhythmia recurrences after an initially successful CA7–11. Given the moderate above mentioned success rates, it would facilitate patients‘ selection for CA with a favorable outcome, if characteristics predicting arrhythmia recurrences would be available. All listed studies were well conducted and identified predictors are reliable, collected data reflect mainly single center data imposed by very well experienced operators. The aim of our study was to identify more general, preferably not selective patients groups based on data entry of the German nation-wide ablation registry as well as including moderate volume centers potentially presenting a more “real-life” oriented view on realistic outcome data after CA for AF. We evaluated the question, whether despite of a formal AF recurrence (documented AF duration >30 seconds) patients still experienced a benefit from the ablation procedure, e.g. reporting a symptom reduction, capacity improvement or less weighted AF episodes
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