Abstract 15162: Effect of Different Cut Points for Defining Success Post-Catheter Ablation for Persistent Atrial Fibrillation - A Sub-Study of the STAR AF II Trial
Introduction: The 30-seconds definition for success post atrial fibrillation (AF) ablation has been chosen as the gold standard but little is known how choosing another cut point would affect ablation trial outcomes.
Hypothesis: This study sought to compare success rates based on different thresholds of defining success.
Methods: Data were collected from patients included in the STAR AF II Trial. Patients were followed-up for 18 months with visit, ECG, and 24 hour Holter at 3, 6, 9, 12 and 18 months. In addition, Trans-telephonic monitoring (TTM) transmission was performed weekly for 18 months and whenever symptoms were reported. After a 3 months blanking period, recurrences were re-analyzed and defined as episodes of AF/AFL/AT >30 seconds (group A), >1 minute (group B), >2 minutes (group C), >6 minutes (group D), >1 hour (group E) and >24 hours (group F). Arrhythmia-free survival curves were generated by the Kaplan-Meier method and compared with the log-rank test.
Results: Five hundred and thirty patients were included in the analysis. Compliance with follow-ups was 85% and for weekly TTM 75%. The pooled success rate for all the three arms in the study was 44% using freedom-from-AF/AFL/AT >30 seconds, for the other cut-off points, the pooled success was 48.1% (B), 53.6% (C), 63.8% (D), 68.3% (E) and 75.1% (F). Log-rank test showed a significant difference between the six survival curves (p < .0001, figure). Compared to group A there was no significant difference in outcome for group B (p = .095). However, all the other cut-offs were significantly higher than A.
Conclusions: The success rate significantly increases as higher thresholds for defining success are used. There is little difference between 30 seconds and one minute, but all other thresholds result in significantly higher success rates.
Author Disclosures: S. Conti: None. C. Jiang: Research Grant; Modest; Biosense Webster. Speakers Bureau; Modest; Biosense Webster, St Jude Medical. T.R. Betts: Research Grant; Modest; St Jude Medical. Honoraria; Modest; Medtronic. Consultant/Advisory Board; Modest; St Jude Medical. J. Chen: Research Grant; Modest; St Jude Medical. Speakers Bureau; Modest; St Jude Medical. I. Deisenhofer: None. R. Mantovan: None. L. Macle: Research Grant; Modest; St Jude Medical. Speakers Bureau; Modest; St Jude Medical. C.A. Morillo: Research Grant; Modest; Boston Scientific, Pfizer, Biosense Webster, Merck. Speakers Bureau; Modest; Boehringer Ingelheim, Bayer, Biotronik. W. Haverkamp: Speakers Bureau; Modest; St Jude Medical. R. Weerasooriya: Speakers Bureau; Modest; Biotronik, Boehringer Ingelheim, Pfizer, Bayer. J. Albenque: Consultant/Advisory Board; Modest; Biosense Webster, St Jude Medical. S. Nardi: None. E. Menardi: None. P. Novak: None. P. Sanders: Research Grant; Modest; Sorin. Speakers Bureau; Modest; Biosense- Webster, Medtronic, St Jude Medical, Boston Scientific. Consultant/Advisory Board; Modest; Biosense-Webster, Medtronic, St Jude Medical, Boston Scientific, CathRx. Research Grant; Significant; Boston Scientific, St Jude Medical, Medtronic, Biotronik. A. Verma: Consultant/Advisory Board; Modest; Bayer, Boehringer Ingelheim, Medtronic, Biosense Webster, St Jude Medical.
- © 2016 by American Heart Association, Inc.