Arquivos Brasileiros de Cardiologia
versión impresa ISSN 0066-782X
SARTINI, Raul José Pádua et al. Radiofrequency ablation of paroxysmal atrial fibrillation: factors determining long-term clinical efficacy. Arq. Bras. Cardiol. [online]. 2008, vol.90, n.2, pp. 122-129. ISSN 0066-782X. http://dx.doi.org/10.1590/S0066-782X2008000200008.
BACKGROUND: Most of the studies on this subject have reported predictors of recurrence of atrial fibrillation after catheter ablation with relatively short follow-up periods. OBJECTIVE: To retrospectively evaluate predictors of long-term recurrence of paroxysmal atrial fibrillation (AF) in patients undergoing pulmonary vein isolation following one single procedure. METHODS: The authors studied a total of 139 patients (102 men; mean age of 55 ± 12 years) undergoing radiofrequency ablation using the ostial or extra-ostial techniques for left atrial approach, combined or not with cavotricuspid isthmus ablation (CTI). Pre, intra and post-ablation variables were evaluated using univariate and multivariate analyses to determine the predictors of recurrence of AF after one procedure. RESULTS: After a 33 ± 12-month follow-up, we observed that a longer time of history of AF, use of more antiarrhythmic drugs, and recurrence of AF within 60 days post-procedure increased the risk of long-term recurrence of AF. On the other hand, the association of atrial flutter and concomitant CTI ablation reduced the risk of recurrence of AF. CONCLUSION: Clinical variables such as time of history of AF and a larger number of antiarrhythmic drugs already used influenced the outcomes of catheter ablation. In patients with associated atrial flutter, simultaneous CTI block significantly reduced the long-term recurrence of atrial fibrillation.
Palabras llave : Atrial fibrillation; catheter ablation; recurrence; follow-up studies.