Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Ablation Techniques D-PO02 - Poster Session II (ID 47) Poster

D-PO02-199 - Pulmonary Vein Capture Is A Predictor For Long-term Success Of Stand-alone Pulmonary Vein Isolation In Patients With Persistent Atrial Fibrillation (ID 1055)


Background: The initial strategy for ablation of persistent AF is controversial and although pulmonary vein (PV) isolation is performed in all patients, the long-term outcomes remain relatively poor.
Objective: The purpose of this study was to determine the role of the electrophysiologic properties of PV in the outcomes after AF ablation.
Methods: 390 stand-alone PV isolation procedures were evaluated. Patients were divided into 4 groups depending on whether PV capture (discrete PV electrogram identified with PV pacing) could be identified after PV isolation or not (control) and whether the patient had persistent or paroxysmal AF. Follow-up time was 20 [IQR: 9-36] mo. Recurrence of arrhythmia was identified as a symptomatic AF event with the need of cardioversion/repeat ablation, or if the burden of AF had not decreased according to rhythm monitoring or subjective symptoms.
Results: Absence of PV capture was associated with earlier AF recurrence in patients with persistent AF (p < 0.01). In case of presence of PV capture the Kaplan-Meier analysis revealed no difference in outcomes between patients with paroxysmal AF (regardless of whether PV capture was present or not) and patients with persistent AF. The demographic characteristics of evaluated groups were not significantly different.
Conclusion: The simple presence of PV capture (and not specific electrophysiologic characteristics of the PV) after PV isolation was associated with an increased likelihood of freedom from recurrent AF during the long-term follow-up after persistent AF ablation. The presence of PV capture may identify those patients with persistent AF in whom PV isolation alone is adequate at the initial ablation procedure.