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Ablation of Paroxysmal and Persistent Atrial Fibrillation: 1‐Year Follow‐Up Through Continuous Subcutaneous Monitoring

2010; Wiley; Volume: 22; Issue: 4 Linguagem: Inglês

10.1111/j.1540-8167.2010.01923.x

1540-8167

Evgeny Pokushalov, Alexander Romanov, G. Corbucci, Sergey Artyomenko, А. Н. Туров, Natalya Shirokova, Alexander Karaskov,

Cardiac pacing and defibrillation studies

Ablation of Paroxysmal and Persistent Atrial Fibrillation . Background: The aim of this prospective observational study was to identify responders to ablation through continuous subcutaneous monitoring for 1 year after ablation in patients with paroxysmal atrial fibrillation (PAF) or persistent AF (PersAF). Method: Patients with symptomatic drug refractory AF were enrolled. Real‐time three‐dimensional (3D) left atrium maps were reconstructed by using a nonfluoroscopic navigation system (CARTO, Biosense‐Webster Inc., Diamond Bar, CA, USA). The ipsilateral left and right pulmonary veins (PVs) were encircled in 1 lesion line by circumferential PV isolation. All patients were implanted with Reveal XT (Medtronic Inc.) for continuous AF monitoring and data collected every month during the 12‐month follow‐up. Results: We enrolled 129 patients (56 ± 9 years, 102 males), all of whom were followed‐up for 12 months after the last ablation procedure: 58 (45%) had a history of PersAF. After only 1 ablation procedure, 76 (59%) of the 129 patients were AF‐free at 12‐month: 48 out of 71 (68%) in the PAF group and 28 out of 58 (48%) in the PersAF group. After 1 or more ablation procedures, 94 (73%) of the 129 patients were AF‐free 12 months after the last procedure: 57 out of 71 (80%) in the PAF group and 37 out of 58 (64%) in the PersAF group. Conclusion: Ablation is highly effective in treating AF, as assessed through detailed 1‐year continuous monitoring: success rate is higher in PAF than in PersAF patients. The use of subcutaneous monitors is a valuable means of identifying responders and nonresponders, and can potentially guide antiarrhythmic and antithrombotic therapies. (J Cardiovasc Electrophysiol, Vol. 22, pp. 369‐375)