CLINICAL OUTCOME OF 4-PULMONARY VEIN ISOLATION IN PATIENTS WITH PERSISTENT ATRIAL FIBRILLATION

摘要

Background: Although the efficacy of pulmonary vein (PV) isolation to suppress the occurrence of paroxysmal atrial fibrillation (AF) has been almost established, its effect on persistent AF is not known yet. The purpose of this study was to investigate and compare the efficacy of all four PV isolation on paroxysmal and persistent AF. Methods and Results: The study subjects were consecutive 68 patients with drug-resistant paroxysmal AF (n = 45) and persistent AF (n = 23), who underwent catheter ablation to isolate all pulmonary veins from left atrium. Effective ablation for AF was defined as the absence of documented sustained AF in ambulatory monitoring and symptoms with or without antiarrhythmic drug (AAD) therapy for follow-up periods of 12+-4 months. All pulmonary veins were successfully isolated in all patients. No significant difference in clinical outcome after a mean of 1.2+-0.5 procedures was noted between paroxysmal and persistent AF (effective rate: 98% and 96%, respectively, P = NS), even though larger left atrial dimension and lower ejection fraction at baseline echocardiogram in the patients with persistent AF than those in the patients with paroxysmal AF. Conclusion: Ostial PV isolation by catheter technique is equally and highly effective in patients with paroxysmal and persistent AF, when all PVs are isolated.