Long-term outcome of catheter ablation in patients with atrial fibrillation originating from nonpulmonary vein ectopy

Hung Yu Chang, Li Wei Lo, Yenn Jiang Lin, Shih Lin Chang, Yu Feng Hu, Cheng Hung Li, Tze Fan Chao, Fa Po Chung, Trung Le Ha, Rahul Singhal, Eric Chong, Wei Hsian Yin, Hsuan Ming Tsao, Ming Hsiung Hsieh, Shih Ann Chen

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Abstract

Introduction: Data regarding the long-term outcome of catheter ablation in patients with nonpulmonary vein (NPV) ectopy initiating atrial fibrillation (AF) are limited. We aimed to evaluate the long-term result of patients with AF who had NPV triggers and underwent catheter ablation. Methods and Results: The study included 660 consecutive patients (age 54 ± 11 years old, 477 males) who had undergone catheter ablation for AF. Group 1 consisted of 132 patients with AF initiating from the NPV, and group 2 consisted of 528 patients with AF initiating from pulmonary vein (PV) triggers only. Patients from Group 1 were younger than those from Group 2 (51 ± 12 years old vs 54 ± 11 years old, P = 0.001) and were more likely to be females (34.4% vs 25.8%, P = 0.049). The incidences of nonparoxysmal AF (36.4% vs 16.3%, P <0.001) and right atrial (RA) enlargement (31.3% vs 19%, P = 0.004) were higher, and the biatrial substrates were worse in Group 1 than those in Group 2 (left atrial voltage 1.5 ± 0.7 mV vs 1.9 ± 0.7 mV, P <0.001, RA voltage 1.6 ± 0.5 mV vs 1.8 ± 0.6 mV, P = 0.014). During a follow-up period of 46 ± 23 months, there was a higher AF recurrence rate in Group 1 than in Group 2 (57.6% vs 38.8%, P <0.001). The independent predictors of AF recurrence were NPV trigger (P <0.001, HR 2, 95% CI 1.4-2.85), nonparoxysmal AF (P = 0.021, HR 1.55, 95% CI 1.07-2.24), larger left atrial diameter (P = 0.002, HR 1.04, 95% CI 1.02-1.07) and worse left atrial substrate (P = 0.028, HR 1.3, 95% CI 1.03-1.64). Conclusion: Compared to AF originating from the PV alone, AF originating from the NPV ectopy showed a worse outcome. (J Cardiovasc Electrophysiol, Vol. 24, pp. 250-258, March 2013)

Original languageEnglish
Pages (from-to)250-258
Number of pages9
JournalJournal of Cardiovascular Electrophysiology
Volume24
Issue number3
DOIs
Publication statusPublished - Mar 2013

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Keywords

  • atrial fibrillation
  • catheter ablation
  • long-term outcome
  • pulmonary vein isolation
  • right atrial triggers
  • superior vena cava

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Chang, H. Y., Lo, L. W., Lin, Y. J., Chang, S. L., Hu, Y. F., Li, C. H., Chao, T. F., Chung, F. P., Ha, T. L., Singhal, R., Chong, E., Yin, W. H., Tsao, H. M., Hsieh, M. H., & Chen, S. A. (2013). Long-term outcome of catheter ablation in patients with atrial fibrillation originating from nonpulmonary vein ectopy. Journal of Cardiovascular Electrophysiology, 24(3), 250-258. https://doi.org/10.1111/jce.12036