Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO03 - Poster Session III (ID 48) Poster

D-PO03-167 - Risk Factors For Progression Of Paroxysmal To Persistent Atrial Fibrillation Following Successful Pv Isolation (ID 1136)


Background: Progression from paroxysmal (PAF) to persistent atrial fibrillation (PerAF) following effective PV isolation (PVI) has important clinical implications, as it is relevant for subsequent management of the arrhythmia.
Objective: We evaluated risk factors responsible for progression of PAF to PerAF following successful PVI.
Methods: Consecutive AF patients that received their first catheter ablation as well as the first redo at our center were identified (n=1352). Patients were included in group 1 if the diagnosis was PAF at both first and redo procedure and group 2 if PAF at index progressed to PerAF at redo. Two blinded electrophysiologists confirmed AF type before the first and the redo ablation procedure. All patients received PV isolation plus isolation of left atrial posterior wall and superior vena cava at the first procedure.
Results: A total of 822 patients remained as PAF at redo, whereas 530 (39%) progressed from PAF to PerAF at the first repeat procedure. Clinical characteristics of the study population are presented in table 1. Group 1 patients were significantly younger and had lower BMI, less number of hypertension and heart failure. Additionally, group 1 patients had better LVEF and smaller LA size. In multivariate analysis, BMI (OR 1.02, 1.01-1.04, p=0.04), hypertension (1.4, 1.08-1.8, p=0.01), heart failure (1.67, 1.03-2.69, p=0.03), LA size (2.75, 2.29-3.31, p<0.001) and LVEF (0.97, 0.95-0.98, p<0.001) were independent predicors of progression of PAF to PerAD.
Conclusion: In our patients, after successful PVI, progression of PAF to PerAF was mediated by independent risk factors such as high BMI, heart failure, hypertension, larger LA size and lower LVEF.