Immediate and long‑term results of conventionally performed radiofrequency catheter ablations of paroxysmal atrial fibrillation

Česká verzia

Authors: R. Lábrová; M. Fiala; O. Toman; J. Špinar
Authors place of work: Interní kardiologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jindřich Špinar, CSc., FESC
Published in the journal: Vnitř Lék 2008; 54(10): 953-960
Category: Original Contributions

Summary

Introduction:
Atrial fibrillation is the most frequent cardiac arrhythmia. Epidemiological studies show sharp increase of incidence and prevalence of atrial fibrillation all over the world. Atrial fibrillation is becoming to be a serious problem, not only clinical, but even social and economical. Aim of the paper was to evaluate immediate and long‑term results of radiofrequency catheter ablation of paroxysmal atrial fibrillation at Dpt. of Internal Medicine – Cardiology, University Hospital Brno.

Methods:
The patients were indicated for ablation, when the anti‑arrhythmic therapy was ineffective. End-point of the ablation was disconnection of myocardial sleeves between left atrium and pulmonary veins and complete electrical isolation of pulmonary veins.

Group of the patients, results:
There were 67 catheter ablations of paroxysmal atrial fibrillation performed within the years 9/2004 to 12/2006 at our department, out of the whole amount of 1,285 ablations of supraventricular tachyarrhythmias from 1995 to 2006. There were 27 women (40%) and 40 men (60%) in our group of patients, with the mean age 56.9 ± 9.5 years. The average ejection fraction of left ventricle was 62 ± 5%, left atrial dimension 42.8 ± 6 mm. The mean follow‑up period was 16.9 ± 10.9 months. The patients were treated before and after the ablation by 1 anti‑arrhythmic drug in 44.8 vs 50%, by 2 drugs in 40.3 vs 14.9% and by 3 drugs in 10.4 vs 9%, respectively. The percentage of patients without any anti‑arrhythmic drug increased after successful ablation from 2.9 to 25.4%, the percentage of patients using amiodarone decreased from 29.8 to 16.4%, propafenon from 29.8 to 16.4% and sotalol from 26.8 to 10.4% respectively. The median of RF application duration was 43.8 min, fluoroscopy time 43.8 min and procedure duration 240 min. The success rates were 87.5% in year 2004, 77.4% in 2005 and 79.2% in 2006.

Conclusion:
Catheter ablation of paroxysmal atrial fibrillation has become a routine curative method in symptomatic patients without major structural heart disease, with ineffective anti‑arrhythmic treatment. Ablation was associated with significant reduction of anti‑arrhythmic and anticoagulation therapy.

Key words:
atrial fibrillation – paroxysmal atrial fibrillation – radiofrequency catheter ablation – electrical isolation of pulmonary veins

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