Predictors Of Late Recurrence Of Atrial Fibrillation After Circumferential Pulmonary Vein Isolation

Background:The success rate of initial catheter ablation of atrial fibrillation(AF) ranges from 22%to 78%,and the predictors of AF recurrence are not completely understood.Object:We accessed the predictive value of pre-procedure factors and left atrial pressure in AF recurrence after a standardized circumferential pulmonary vein isolation procedure.Methods and results:A cohort of 108 consecutive patients undergoing circumferential pulmonary vein isolation procedure for AF refractory to antiarrhythmic drugs was included in this study.A complete medical history and an echocardiogram were taken before procedure.Left atrial pressure was directly measured after transseptal puncture. CARTO^TM-guided ablation was performed in every case with the complete isolation of all pulmonary veins and additional lineal lesions.Follow-up(10.0±4.3 months) was completed by 102 patients(56 patients had paroxysmal AF and 46 had persistent AF), 18(17.6%) patients had AF recurrence.The risk of AF recurrence increased with larger left atrial dimension(38.8±7.9mm vs.44.1±10.4mm,P=0.018),and if AF was persistent (39.3%vs.72.2%,P=0.011).In the multivariate analysis only persistent AF was the independent predictor of AF recurrence after ablation(P=0.014).Conclusion:Only the type of AF is independent predictor of AF recurrence after ablation.