Five-year follow-up after catheter ablation of persistent atrial fibrillation using the stepwise approach and prognostic factors for success

Circulation. Arrhythmia and Electrophysiology
Doreen SchreiberDaniel Steven

Abstract

In the meantime, catheter ablation is widely used for the treatment of persistent atrial fibrillation (AF). There is a paucity of data about long-term outcomes. This study evaluates (1) 5-year single and multiple procedure success and (2) prognostic factors for arrhythmia recurrences after catheter ablation of persistent AF using the stepwise approach aiming at AF termination. A total of 549 patients with persistent AF underwent de novo catheter ablation using the stepwise approach (2007-2009). A total of 493 patients were included (Holter ECGs ≥ every 6 months). Mean follow-up was 59 ± 16 months with 2.1 ± 1.1 procedures per patient. Single and multiple procedure success rates were 20.1% and 55.9%, respectively (80% off antiarrhythmic drug). Antiarrhythmic drug-free multiple procedure success was 46%. Long-term recurrences (n=171) were paroxysmal AF in 48 patients (28%) and persistent AF/atrial tachycardia in 123 patients (72%). Multivariable recurrent event analysis revealed the following factors favoring arrhythmia recurrence: failure to terminate AF during index procedure (hazard ratio [HR], 1.279; 95% confidence interval [CI], 1.093-1.497; P = 0.002), number of procedures (HR, 1.154; 95% CI, 1.051-1.267; P = 0.003), female...Continue Reading

Associated Clinical Trials

References

Oct 1, 1989·Cardiovascular Research·F SoltiA Juhász-Nagy
Sep 3, 1998·The New England Journal of Medicine·M HaïssaguerreJ Clémenty
Aug 22, 2003·Journal of Cardiovascular Electrophysiology·José Jalife
Jun 3, 2004·Journal of the American College of Cardiology·Koonlawee NademaneeTachapong Ngarmukos
Nov 3, 2004·Circulation·Jayakumar SahadevanAlbert L Waldo
Nov 24, 2005·Journal of Cardiovascular Electrophysiology·Michel HaïssaguerrePierre Jaïs
Nov 24, 2005·Journal of Cardiovascular Electrophysiology·Michel HaïssaguerrePierre Jaïs
Aug 17, 2006·Journal of Cardiovascular Electrophysiology·Thomas RostockMichel Haïssaguerre
Sep 23, 2006·Journal of Cardiovascular Electrophysiology·Aamir CheemaHugh Calkins
Jul 20, 2007·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Giovanni B ForleoMassimo Mantica
May 9, 2008·Journal of Cardiovascular Electrophysiology·Matthew WrightPierre Jais
Jul 11, 2008·European Heart Journal·Sébastien KnechtMichel Haïssaguerre
Mar 10, 2009·European Heart Journal·Mark D O'NeillMichel Haïssaguerre
Apr 1, 2008·Circulation. Arrhythmia and Electrophysiology·Michel HaïssaguerrePierre Jaïs
Nov 6, 2009·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Emanuele BertagliaGiuseppe Stabile
Mar 9, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Anthony G BrooksPrashanthan Sanders
Mar 9, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Claude S ElayiAndrea Natale
Mar 26, 2010·Circulation. Arrhythmia and Electrophysiology·Wendy S TzouEdward P Gerstenfeld
Jun 28, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Thomas RostockStephan Willems
Aug 23, 2011·Circulation. Arrhythmia and Electrophysiology·Sonia AmmarIsabel Deisenhofer
Nov 9, 2011·Expert Review of Cardiovascular Therapy·Dimpi PatelCarlos A Morillo
Jun 23, 2012·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Kai MuellerleileStephan Willems
Aug 28, 2012·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·A John CammUNKNOWN Document Reviewers
Oct 16, 2012·Journal of the American College of Cardiology·Roland Richard TilzFeifan Ouyang
Dec 21, 2012·Journal of Cardiovascular Electrophysiology·Sonia AmmarIsabel Deisenhofer
Feb 5, 2013·Journal of Cardiovascular Electrophysiology·Michel HaissaguerreRemi Dubois
Jul 5, 2013·Pacing and Clinical Electrophysiology : PACE·Xiao-Dong ZhangXu Liu
Feb 25, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Marco ScaglioneFiorenzo Gaita
Sep 30, 2014·Circulation. Arrhythmia and Electrophysiology·Matteo AnselminoFiorenzo Gaita

❮ Previous
Next ❯

Citations

Feb 5, 2016·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Johan ProbstCarina Blomström Lundqvist
Feb 4, 2016·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Cas TeunissenPeter Loh
Oct 30, 2015·Journal of Cardiovascular Electrophysiology·Hans KottkampDoreen Schreiber
Nov 17, 2015·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Jonathan ChrispinSaman Nazarian
Dec 25, 2015·Journal of the American College of Cardiology·Matthew Wright
Mar 5, 2016·Journal of Internal Medicine·T MaurerK-H Kuck
Oct 4, 2015·The Journal of Thoracic and Cardiovascular Surgery·Matthew C HennRalph J Damiano
Jul 29, 2015·Journal of Cardiovascular Electrophysiology·Andreas RilligFeifan Ouyang
Oct 27, 2016·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Serge BovedaPedro Sousa
Jun 12, 2016·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Maura M ZyllaDierk Thomas
Jul 9, 2016·European Heart Journal·Paulus Kirchhof, Hugh Calkins
Jul 21, 2016·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Melanie GunawardeneB A Hoffmann
Jul 17, 2016·Journal of Cardiovascular Electrophysiology·Nicholas Y TanChristopher J McLEOD
Aug 28, 2016·European Heart Journal·Paulus KirchhofUNKNOWN ESC Scientific Document Group
Nov 4, 2016·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Paulus KirchhofKatja Zeppenfeld
Sep 25, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Paulus KirchhofKatja Zeppenfeld
Oct 25, 2016·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Stephen Gaeta, James P Daubert
Nov 9, 2016·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Bruno ReissmannAndreas Metzner
Oct 27, 2015·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Nikolaos DagresUNKNOWN Scientific Initiatives Committee, European Heart Rhythm Association
Oct 22, 2016·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Gustavo R GoldenbergSheldon M Singh
Mar 8, 2017·Expert Review of Cardiovascular Therapy·Louisa O'NeillSteven E Williams
Nov 21, 2017·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Vikas Kuriachan, Carlos A Morillo
May 13, 2017·Journal of Atrial Fibrillation·Martin Fiala
Dec 1, 2017·Circulation Journal : Official Journal of the Japanese Circulation Society·Hideharu Okamatsu, Ken Okumura
Aug 14, 2018·Expert Review of Cardiovascular Therapy·Katie Walsh, Francis Marchlinski
Mar 3, 2018·Circulation Research·Jordi HeijmanStanley Nattel
Nov 17, 2017·Circulation. Arrhythmia and Electrophysiology·Prabhat Kumar, J Paul Mounsey
Oct 12, 2017·Circulation. Arrhythmia and Electrophysiology·Tilman MaurerFeifan Ouyang
Oct 6, 2018·International Journal of Clinical Practice·Vicente Bertomeu-González, Jesus Castillo-Castillo
Dec 3, 2016·Current Opinion in Cardiology·Gianluigi Bisleri, Benedict Glover
Oct 19, 2017·F1000Research·Richard BondPaulus Kirchhof
Dec 24, 2018·Journal of Cardiovascular Electrophysiology·Konstantinos E IliodromitisTom De Potter
Dec 20, 2019·Pacing and Clinical Electrophysiology : PACE·Annina StauberPhilipp Sommer
Mar 29, 2020·Journal of Cardiovascular Electrophysiology·John LarsonStacy Westerman

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Anti-Arrhythmic Drug Therapies

Anti-arrhythmic drugs are used to prevent abnormal heart rhythms. These medications are used in conditions including, ventricular tachycardia, ventricular fibrillation and atrial fibrillation. Discover the latest research on anti-arrhythmic drug therapies here.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Antiarrhythmic Agents: Mechanisms of Action

Understanding the mechanism of action of antiarrhythmic agents is essential in developing new medications as treatment of cardiac arrhythmias is currently limited by the reduced availability of safe and effective drugs. Discover the latest research on Antiarrhythmic Agents: Mechanism of Action here.