Experience of Radiofrequency Catheter Ablation of Atrial Fibrillation in Patients with Structural Heart Disease: Comparable Clinical Outcome Despite Advanced Atrial Remodeling

Jae Sun Uhm, Boyoung Joung, Hye Jin Hwang, Moon Hyoung Lee, huinam pak

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Abstract

Backgrounds: We hypothesized radiofrequency Catheter ablation (RFCA) of atrial fibrillation (AF) in patients with structural heart disease (SHD) results in outcomes comparable to those with lone AF. Methods: We included 428 patients (age, 56.0 ±11.0 years; male, 77.3%; paroxysmal AF, 69.4%; persistent AF, 30.6%) who underwent RFCA of AF and compared imaging, hemodynamic, electrophysiologic parameters and clinical outcome between the patients with (n=77) and without (n=351) SHD. SHD included coronary artery disease (CAD, 57.1%), valvular heart disease (23.4%), cardiomyopathy (10.4%), heart failure (6.5%), and congenital heart disease (2.6%). Results: In patients with SHD, LA diameter (p<0.001), LA volume index (p<0.001), E/E' (p<0.001), LA mean pressure (p=0.003), effective refractory period (ERP: p=0.027), and ANP (p=0.005) were significantly higher than those without SHD. In patients with CAD (n=44), there was no significant differences in terms of culprit vessels or number of coronary lesions. There were no significant differences of complications (2.6% vs. 3.7%) and recurrence rates after blanking period (21.1% [28.6% with anti-arrhythmic drug [AAD]] vs. 20.2% [25.9% with AAD]) during 12.7±5.9 months in SHD and no SHD groups, respectively (p=0.859). Conclusion: RFCA of AF in patients with selected SHD results in clinical outcome comparable to those with lone AF, in spite of advanced LA remodeling.

Original languageEnglish
Number of pages1
JournalJournal of Arrhythmia
Volume27
Issue number4
DOIs
Publication statusPublished - 2011 Jan 1

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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