Back to Search
Start Over
Comparison of Radiofrequency Catheter Ablation Between Asymptomatic and Symptomatic Persistent Atrial Fibrillation: A Propensity Score Matched Analysis
- Source :
- Journal of Cardiovascular Electrophysiology. 27:531-535
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- RFCA for Asymptomatic Persistent AFBackground Whether patients with asymptomatic atrial fibrillation (AF) could benefit from radiofrequency catheter ablation (RFCA) remains unclear. This study aimed to compare the outcomes of RFCA between asymptomatic and symptomatic AF. Methods Sixty-six patients with asymptomatic persistent AF who underwent the primary ablation for AF were enrolled; 132 patients with symptomatic persistent AF were matched using propensity score matching. All patients underwent circumferential pulmonary vein isolation in combination with linear ablation using AF termination as the primary procedural endpoint. Results Sinus rhythm (SR) was restored by ablation in 18 (27.3%) patients in the asymptomatic group and 93 (70.5%) in the symptomatic group (P < 0.001). Combined with intravenous infusion of ibutilide (1 mg), the numbers were 45 (68.2%) and 116 (87.8%), respectively (P = 0.001). At 1-year follow-up, SR was present in 23 (34.8%) patients in the asymptomatic group and 78 (59.1%) in the symptomatic group without any antiarrhythmic medication after a single procedure (P = 0.001). Of the 43 patients experiencing recurrence in the asymptomatic group, 16 (37.2%) had recurrent atrial tachycardia (AT)-related symptoms. Multivariate analysis showed that asymptomatic AF was independently associated with AF failed to be terminated by ablation (OR: 7.1; 95% CI: 3.4 to 14.9; P < 0.001) and recurrence (OR: 2.2; 95% CI: 1.1 to 4.4; P = 0.018). Patients with asymptomatic AF showed less improvement in quality of life postablation than those with symptoms. Conclusion Current catheter ablation techniques showed worse outcomes in asymptomatic AF patients than in those with symptoms. Recurrent AT could cause significant symptoms in previously asymptomatic patients.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Ibutilide
Catheter ablation
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Asymptomatic
Pulmonary vein
03 medical and health sciences
0302 clinical medicine
Recurrence
Risk Factors
Physiology (medical)
Internal medicine
Atrial Fibrillation
Odds Ratio
medicine
Humans
Sinus rhythm
030212 general & internal medicine
Propensity Score
Atrial tachycardia
Chi-Square Distribution
business.industry
Atrial fibrillation
Recovery of Function
Middle Aged
medicine.disease
Ablation
Surgery
Logistic Models
Treatment Outcome
Pulmonary Veins
Asymptomatic Diseases
Multivariate Analysis
Catheter Ablation
Quality of Life
Cardiology
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 15408167 and 10453873
- Volume :
- 27
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiovascular Electrophysiology
- Accession number :
- edsair.doi.dedup.....bff71e30a3b49ecec603cef017f5c6ca