Clinical outcome of left atrial ablation for paroxysmal atrial fibrillation is related to the extent of radiofrequency ablation

  • Demosthenes Katritsis
  • Kenneth A. Ellenbogen
  • Eleftherios Giazitzoglou
  • Dimitrios Sougiannis
  • George Paxinos
  • Nicolaos Fragakis
  • A. John Camm
Article

DOI: 10.1007/s10840-008-9247-9

Cite this article as:
Katritsis, D., Ellenbogen, K.A., Giazitzoglou, E. et al. J Interv Card Electrophysiol (2008) 22: 31. doi:10.1007/s10840-008-9247-9

Abstract

Background

The exact mechanism of eliminating atrial fibrillation (AF) by catheter ablation techniques is not known. We investigated whether the extent of atrial damage conferred by radiofrequency lesions is a predictor of success after ablation, regardless of the method employed for ablation.

Methods

Ninety consecutive patients with paroxysmal AF subjected to ostial–antral pulmonary vein isolation (n = 41) or circumferential (n = 49) catheter ablation were studied.

Results

At 1 year follow-up, 16 out of 41 patients (39%) with ostial–antral ablation and 16 out of 49 patients (32.6%) with circumferential ablation had AF recurrences (p = 0.5). The mean duration of radiofrequency ablation lesions was statistically significantly shorter in patients with recurrence of AF compared to those with sinus rhythm 1 year after ablation (22.3 ± 4.2 min vs. 27.2 ± 4.5 min, respectively, p value < 0.001). Radiofrequency ablation time was inversely associated with the risk of recurrence of AF 1 year after ablation and this relationship remained even after adjustment for potential confounding factors such as age, sex, left atrial size, and type of ablation technique (ostial–antral or circumferential; HR  =  0.80, 95% CI: 0.72–0.87, p < 0.001).

Conclusions

Duration of radiofrequency energy delivery is an independent predictor of clinical outcome at 1 year follow-up both among patients undergoing circumferential as well as ostial–antral ablation.

Keywords

Atrial fibrillationAblationCircumferentialOstialAntral

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Demosthenes Katritsis
    • 1
  • Kenneth A. Ellenbogen
    • 2
  • Eleftherios Giazitzoglou
    • 1
  • Dimitrios Sougiannis
    • 1
  • George Paxinos
    • 1
  • Nicolaos Fragakis
    • 1
  • A. John Camm
    • 3
  1. 1.Department of CardiologyAthens EuroclinicAthensGreece
  2. 2.Division of CardiologyMedical College of VirginiaRichmondUSA
  3. 3.Cardiac and Vascular SciencesSt George’s, University of LondonLondonUK