136 Long term efficacy of catheter ablation for AF: impact of additional targeting of fractionated electrograms

• DOI: 10.1136/hrt.2010.196113.5
• Publication Date: 2016-01-07T01:47:51Z
• Authors: R J Hunter; T J Berriman; I Diab; V Baker; M Finlay; L Richmond; E Duncan; R Kamdar; G Thomas; D Abrams; M Dhinoja; M J Earley; S Sporton; R J Schilling
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

<h3>Introduction</h3> Published long term follow-up data for catheter ablation (CA) of AF is scarce. Although many centres perform complex fractionated electrograms (CFE) in addition to pulmonary vein isolation (PVI), evidence this conflicting. We sought investigate efficacy CA and the impact ablating CFE PVI linear lesions persistent (PeAF). <h3>Methods</h3> Consecutive cases from 2002 2007 at St Bartholomew9s Hospital were analysed. All patients underwent wide area circumferential with confirmation electrical isolation. For PeAF added roof mitral isthmus, additional targeting 2005. Data collected a prospective database. Attempts made contact all September 2009. Failure was defined as documented recurrence or other atrial tachyarrhythmia (AT) lasting ≥30 s. As repeated procedures AF/AT can distort patterns late recurrence, analysed following first cluster when patient emerged their 3 month blanking period free (or failure accepted), that is, successfully eliminated whether after one several. <h3>Results</h3> Two hundred eighty-five 530 procedures. Mean age 57±11 years, 75% male, 20% had structural heart disease 53% paroxysmal AF. Left diameter 4.3±0.8 cm 17% left ventricular systolic dysfunction. number 1.9 per (1.7 PAF 2.0 PeAF). Procedural complications included stroke TIA 0.6% (all which resolved) pericardial effusions drained without sequelae 1.7%. There no peri-procedural deaths. Of 285 patients, 270 contacted follow-up. During 3.3 (2.4 7.5) years procedure, there seven deaths (unrelated AF) three strokes (0.3% year). Freedom 2.7 (0.2 7.4) last procedure 86% 68% PeAF. Most occurred year, &gt;3 occurring 3/100 Kaplan–Meier analysis showed improved outcome (p=0.04), trend towards final (p=0.13). <h3>Conclusion</h3> Long freedom achievable majority low rates recurrence. Rates periprocedural are low, adverse events including few. Targeting improves