Abstract 15258: The Association of Genetic Polymorphism of rs2106261 in ZFHX3 and ‘Super-responder’ to Catheter Ablation Among the Patients With Long-standing Persistent Atrial Fibrillation
Introduction: The radiofrequency catheter ablation (RFCA) is challenging in patients with long-standing persistent atrial fibrillation (PeAF) and its clinical outcome is highly variable. Genome-wide association studies (GWAS) have identified that the rs2106261 polymorphism in ZFHX3 is associated with non-valuvluar AF.
Hypothesis: We tested the association between the “super-responder” to the radiofrequency catheter ablation (RFCA) and the rs2106261 polymorphism among the patients with long-standing persistent AF.
Methods: We included consecutive 207 patients with long-standing PeAF (79.2% male, age 58.0±9.7 years and follow-up interval 21 (16-34) months) who underwent RFCA for symptomatic long-standing PeAF. The super-responders were defined as the patients without early or clinical recurrence of AF at least for 12 months of post-procedural follow-up period without taking anti-arrhythmic drug. We looked for the characteristics of super-responders in clinical profiles, ECG in sinus rhythm, 3D-left atrial (LA) CT, or genotypes of the rs2106262.
Results: 1. Fifty two patients (25.1%) were categorized as super-responders. Super-responders were younger (55.5±9.6 vs. 58.9±9.6 years old, p=0.028) and had shorter AF duration (44.9 [25.4-73.1] vs. 65.1 [34.1-113.6] month, p=0.010), shorter QTc (435.1±27.8 vs. 447.3±29.1 msec, p=0.007), lower negative P wave amplitude in lead V1 (0.07±0.03 vs. 0.08±0.04, p=0.034), and smaller LA volume index (CT) (75.2±21.0 vs. 88.2±24.1, p=0.001) than recurred patient group. 2. In additive model, the minor allele frequency of the rs2106261 was higher in super-responders (52.2%) than in recurred group (40.9%, p=0.058). 3. In multivariate analyses, LA volume index (adjusted OR=0.973, 95% CI 0.955-0.992, p=0.006) and genetic polymorphism of the rs2106261 (adjusted OR=1.808, 95% CI 1.034-3.163, p=0.038) were independently associated with super-responder to RFCA among the patients with long-standing persistent AF.
Conclusion: Although the recurrence rate after catheter ablation for long-standing persistent AF is still high, pre-procedural LA volume index or the rs2106261 polymorphism may be helpful for the selection of good candidate for RFCA.
Author Disclosures: J. Park: None. J. Park: None. J. Uhm: None. B. Joung: None. M. Lee: None. H. Pak: None.
- © 2014 by American Heart Association, Inc.