Atrial Substrate Underlies the Recurrence after Catheter Ablation in Patients with Atrial Fibrillation
- Authors
- Baek, Yong-Soo; Choi, Jong-Il; Kim, Yun Gi; Lee, Kwang-No; Roh, Seung-Young; Ahn, Jinhee; Kim, Dong-Hyeok; Lee, Dae In; Hwang, Sung Ho; Shim, Jaemin; Kim, Jin Seok; Kim, Dae-Hyeok; Park, Sang-Weon; Kim, Young-Hoon
- Issue Date
- 10월-2020
- Publisher
- MDPI
- Keywords
- atrial fibrillation; catheter ablation; substrate; magnetic resonance imaging
- Citation
- JOURNAL OF CLINICAL MEDICINE, v.9, no.10
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF CLINICAL MEDICINE
- Volume
- 9
- Number
- 10
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/53055
- DOI
- 10.3390/jcm9103164
- ISSN
- 2077-0383
- Abstract
- Prediction of recurrences after catheter ablation of atrial fibrillation (AF) remains challenging. We sought to investigate the long-term outcomes after AF catheter ablation. A total of 2221 consecutive patients who underwent catheter ablation for symptomatic AF were included in this study (mean age 55 +/- 11 years, 20.3% women, and 59.0% paroxysmal AF). Extensive ablation, in addition to circumferential pulmonary vein isolation, was more often accomplished in patients with non-paroxysmal AF than in those with paroxysmal AF (87.4% vs. 25.3%, p < 0.001). During a median follow-up of 54 months, sinus rhythm (SR) was maintained in 67.1% after index procedure. After redo procedures in 418 patients, 83.3% exhibited SR maintenance. Recurrence rates were similar for single and multiple procedures (17.4% vs. 16.7%, p = 0.765). Subanalysis showed that the extent of late gadolinium enhancement (LGE), as assessed by cardiac magnetic resonance, is greater in patients with recurrence than in those without recurrence (36.2 +/- 23.9% vs. 21.8 +/- 13.7%, p < 0.001). Cox-regression analysis revealed that non-paroxysmal AF (hazard ratio (HR) 2.238, 95% confidence interval (CI) 1.905-2.629, p < 0.001), overweight (HR 1.314, 95% CI 1.107-1.559, p = 0.020), left atrium dimension >= 45 mm (HR 1.284, 95% CI 1.085-1.518, p = 0.004), AF duration (HR 1.020 per year, 95% CI 1.006-1.034, p = 0.004), and LGE >= 25% (HR 1.726, 95% CI 1.330-2.239, p < 0.001) are significantly associated with AF recurrence after catheter ablation. This study showed that repeated catheter ablation improves the clinical outcomes of patients with non-paroxysmal AF, suggesting that AF substrate based on LGE may underpin the mechanism of recurrence after catheter ablation.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - Graduate School > Department of Biomedical Sciences > 1. Journal Articles
- College of Medicine > Department of Medical Science > 1. Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.