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Background:The predictive value of termination of atrial fibrillation (AF) during catheter ablation (CA) during a long-term follow-up is not known.Methods:We studied the predictive value of AF termination (spontaneous or induced) during ablation in patients who underwent CA of persistent and paroxysmal AF and followed them for recurrence of AF/atrial flutter (FL).Results:Of 187 patients (male: 75%, mean age: 60.3 ± 10.7 years) who underwent CA of AF, 65 (34.8%) patients had termination during the initial CA. A mean number of 1.4 ± 0.6 ablations were performed during follow-up in both groups. There were no significant differences in baseline characteristics including age, gender, race, body mass index, left ventricular ejection fraction, and presence of hypertension, diabetes, and valvular disease.During a median (±1SE) follow-up of 5.23 ± 0.17 years, a significantly higher percentage of patients who had termination during CA were in sinus rhythm as compared to patients who did not have termination during CA (87.6 vs 63.1%, p < 0.001). Cox regression analysis confirmed termination of AF during ablation as a predictor of whether the patient was in sinus rhythm at time of last follow-up (OR: 0.24, 95% CI 0.09 to 0.62, p = 0.003). Kaplan-Meier survival analysis shows significantly decreased time to recurrence in patients who did not have AF termination than patients who had AF termination during CA.Conclusion:The present study identifies termination of AF during CA as a predictor of successful ablation during 5-year follow-up.

Background:The presence of obesity in patients who underwent catheter ablation (CA) of atrial fibrillation (AF) is thought to be a predictor of poor outcomes.Methods:We studied the long-term success of CA of AF in patients with mild to severe obesity and followed them for recurrence of AF/atrial flutter (FL).Results:Of 185 patients (mean age: 60.3 ± 10.7 years, male: 75%), 24 (13%) patients had a normal body mass index (BMI < 25.0 kg/m2), 53 (28.6%) patients were overweight (BMI 25.0-29.9 kg/m2), 78 (42.2%) patients were obese (BMI 30.0-39.9 kg/m2) and 30 (16.2%) had severe obesity (BMI > 40 kg/m2). There were no significant differences in baseline characteristics including age, gender, race, left ventricular ejection fraction, and presence of hypertension, diabetes, and valvular disease. Number of ablations performed in the normal, overweight, obese, and severe obesity groups were 1.3 ± 0.5, 1.4 ± 0.6, 1.5 ± 0.6, and 1.5 ± 0.7, respectively. During a median (±1SE) follow-up of 5.23 ± 0.17 years, 79% in the normal BMI, 70% in overweight, 41% in obese, and 80% in severe obesity group were in sinus rhythm. There was no significant difference among all four groups regarding recurrence of AF/AFL (p=NS). Kaplan-Meier survival analysis showed no significant difference in time to recurrence of AF/AFL based on BMI.Conclusion:Severity of obesity does not predict recurrence of AF/AFL after CA during long-term follow-up.