Introduction: Natural history of atrial fibrillation (AF) is characterized by a gradual duration and frequency increase of relapses until the definitive shift to permanent AF. Heart disease and comorbidities modulate AF progression. Our aim is to identify long-term predictors of AF progression in a large cohort of patients undergoing AF transcatheter ablation (AFTCA). Methods: Eight hundred eighty-nine patients (mean age 57±11 years, 53.3% paroxysmal, 40.5% persistent and 6.2% long-standing AF) underwent AFTCA. All patients received pulmonary vein isolation while linear lesions were reserved for cardiomyopathies/comorbidities, Persistent/long lasting AF or in case of redo procedures. Results: After a median follow up of 61 (38-84) months, AF progression occurred in 57 (6.4%) cases. Stratifying by baseline AF subtype an increasing trend in arrhythmia progression emerged: 2.7% of patients with paroxysmal, compared to 10.0% with persistent and 14.6% with long-standing AF (p<0.001). AF progression was reported in 9.1% of the 623 (70.1%) patients presenting baseline comorbidities/cardiomyopathies but in none of 266 (29.9%) with lone AF (Figure, p<0.001). At multivariate analysis only cardiomyopathies/comorbidities and baseline persistent/long standing AF were independent predictors of progression (OR 11.3 CI 95% 2.6-48 p<0.001 and OR 1.6 CI 95% 1.2-2.1 p<0.001). Conclusions: Cardiomyopathies/comorbidities and an AF clinical history more advanced than a paroxysmal form predict AF progression, despite AFTCA, over a long-term follow-up

LONG-TERM PROGRESSION TO PERMANENT ATRIAL FIBRILLATION FOLLOWING TRANSCATHETER ABLATION: A LARGE SINGLE CENTER EXPERIENCE

BATTAGLIA, Alberto;ANSELMINO, Matteo;GALLO, Cristina;CASTAGNO, Davide;GAITA, Fiorenzo
2014-01-01

Abstract

Introduction: Natural history of atrial fibrillation (AF) is characterized by a gradual duration and frequency increase of relapses until the definitive shift to permanent AF. Heart disease and comorbidities modulate AF progression. Our aim is to identify long-term predictors of AF progression in a large cohort of patients undergoing AF transcatheter ablation (AFTCA). Methods: Eight hundred eighty-nine patients (mean age 57±11 years, 53.3% paroxysmal, 40.5% persistent and 6.2% long-standing AF) underwent AFTCA. All patients received pulmonary vein isolation while linear lesions were reserved for cardiomyopathies/comorbidities, Persistent/long lasting AF or in case of redo procedures. Results: After a median follow up of 61 (38-84) months, AF progression occurred in 57 (6.4%) cases. Stratifying by baseline AF subtype an increasing trend in arrhythmia progression emerged: 2.7% of patients with paroxysmal, compared to 10.0% with persistent and 14.6% with long-standing AF (p<0.001). AF progression was reported in 9.1% of the 623 (70.1%) patients presenting baseline comorbidities/cardiomyopathies but in none of 266 (29.9%) with lone AF (Figure, p<0.001). At multivariate analysis only cardiomyopathies/comorbidities and baseline persistent/long standing AF were independent predictors of progression (OR 11.3 CI 95% 2.6-48 p<0.001 and OR 1.6 CI 95% 1.2-2.1 p<0.001). Conclusions: Cardiomyopathies/comorbidities and an AF clinical history more advanced than a paroxysmal form predict AF progression, despite AFTCA, over a long-term follow-up
2014
Heart Rhythm
San Francisco
07/05/2014-10/05/2014
11
5
188
188
http://ac.els-cdn.com/S1547527114003105/1-s2.0-S1547527114003105-main.pdf?_tid=434781ce-dd25-11e4-91b2-00000aacb360&acdnat=1428411464_bd0bb9e6a6c2663f88880ab82a881bd4
Alberto Battaglia; Matteo Anselmino; Marco Scaglione; Cristina Gallo; Davide Castagno; Federico Ferraris; Domenico Caponi;Paolo Di Donna; Fiorenzo Gai...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/158643
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