Abstract 23238: Pulmonary Vein Isolation Alone Is An Effective Rhythm Control Strategy In Patients With Persistent Atrial Fibrillation Those Changed To Paroxysmal Type With Antiarrhythmic Drug Therapy: A Multi-center Prospective Randomized Study
Background: Type of atrial fibrillation (AF) can change depending on the condition and time, and some of patients with initially presented persistent AF (PeAF) changed to paroxysmal AF (PAF) after anti-arrhythmic drug (AAD) medication and/or cardioversion (CV). We hypothesized that CPVI alone is an effective rhythm control strategy for radiofrequency catheter ablation (RFCA) in patients with PeAF to PAF.
Methods: We prospectively enrolled consecutive 113 patients with PeAF to PAF (male 75.2%, 60.4±10.1 years old) and randomly assigned them to either CPVI alone group (n=58) or the CPVI plus linear ablation group (posterior box + anterior line; Dallas lesion set; n=55). The primary outcome was freedom from clinical recurrence of AF after RFCA.
Results: 1. Compare to CPVI+linear ablation group, CPVI alone group required shorter procedure (185.8±57.5min vs. 212.2±63.7min, P=0.025) and ablation times (4917.7±1119.9sec vs. 6186.9±1418.7sec, P<0.001) without significant difference in procedure related major complication rate (3.4%, vs. 1.8%, P=0.590). 2. During the 18.6±11.4 months of follow-up, the clinical recurrence rates were not significantly different between CPVI alone group (19.0%) and CPVI+linear ablation group (29.1%, P=0.271). 3. AAD utility rates after RFCA were not significantly different between two groups (27.6% vs. 38.2%, P=0.316). 4. AAD free AF recurrence was not significantly different between two groups (Log-rank, P=0.208).
Conclusion: CPVI alone is an effective rhythm control strategy with shorter procedure time for PeAF who were converted as PAF with AADs after external electrical cardioversion, compared to CPVI with additional linear ablation.
Author Disclosures: H. Yu: None. J. Shim: None. J. Park: None. I. Kim: None. T. Kim: None. J. Uhm: None. B. Joung: None. M. Lee: None. Y. Kim: None. H. Pak: None.
- © 2016 by American Heart Association, Inc.