Clinical Analysis Of Catheter Ablation For Atrial Fibrillation Patients With Permanent Pacemaker

Objective This study was designed to analyze long-term effect of catheter ablation for atrial fibrillation(AF) patients with permanent pacemaker and to investigate the possible factors which may influence the results.Methods Seventy-five consecutive AF patients with permanent pacemaker undergoing first-time catheter ablation between January 2008 and July 2015 in Beijing Anzhen Hospital, Center AF were included as AF + Pacemaker group,including 44 paroxysmal AF patients and 31 persistents. And 300 age- and gender-matched control subjects without a permanent pacemaker(on 1:4 basis) as AF group. Baseline data were collected and all patients had been regularly followed-up after catheter ablation to demonstrate their sinus rhythm maintenance.Results During a median follow-up period of 18(6,36) months, the AF recurrence rate was 42.7% for paroxysmal AF patients(220 patients in total), a K-M curve shows that the patients in the Pacemaker+AF group had a higher rate of recurrence of atrial tachyarrhythmia(ATa) than those in the AF group(59.1% vs. 38.6%, P = 0.006 by log-rank test, Figure-1). A Cox regression analysis adjusted for sex, left atrial diameter and presence of pacemaker identified pacemaker as an independent predictor for the recurrence of AF(hazard ratio 1.607, 95% confidence interval 1.014-2.549, p=0.044). For persistent AF patients(155 patients in total) the recurrence rate was 53.5%, there was no statistically significant difference between the Pacemaker + AF group and the AF group(51.6% vs. 54.0%, P = 0.920 by log-rank test, Figure-2).Conclusions It seems that paroxysmal AF patients with a permanent pacemaker were at an increased risk of recurrence of AF after catheter ablation while persistent AF ones may not.