Abstract 14360: Very Late Recurrences of Atrial Arrhythmia After Ablation of Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy: The Importance of Non Pv Triggers
Introduction: Radiofrequency catheter ablation of atrial fibrillation in patients with hypertrophic cardiomyopathy (HCM) has shown satisfactory results at the mid and short term follow up. We sought to determine the outcomes at the long term follow-up.
Methods: 43 consecutive patients with HCM undergoing catheter ablation of atrial fibrillation at different Institutions have been prospectively enrolled in this study. Pulmonary vein antrum and posterior wall were isolated in all patients. Patients were followed-up by event recordings, 7-day Holter and office visit.
Results: The baseline variables were:age 59±8 years, LA size 4.6±0.8 cm; with paroxysmal in 28%, new onset persistent in 42% and long standing persistent in 30%. After a mean of 1.6 procedures the success rate was 76% off AADs and increased to 91% if the patients took their previously ineffective medication. 9% of the patients remained in AF or Atrial Flutter. After an average of 43±8 months follow up, 47% of the patients had recurrence of AF/AT. Most of the recurrences occurred between 16 and 23 months. In all patients an additional procedure was performed. During the redo procedure, PVs and posterior wall remained isolated in 82% of the cases. In all recurrences extra PVs triggers were documented and ablated. At 14±7 moths follow up after the redo procedures, 94% of the patients remained free from AF/AT off AADs. No complications were reported in this series of patients.
Conclusion: The results presented in our study show that catheter ablation of AF in patients with HCM is feasible and safe. At the long term follow up, non PVs triggers seem to be responsible of AF/AT recurrences in a significant number of patients. Whether ablation of non PV triggers should be attempted at the time of the first procedure or if they represent a late phenomenon requires further investigation.
- © 2011 by American Heart Association, Inc.