Predictors of Recurrence After Catheter Ablation of Persistent Atrial Fibrillation

Abstract

Catheter ablation of atrial fibrillation (AF) has been increasingly used to treat symptomatic patients.Within the last years a growing interest in ablation of persistent AF forms has evolved.Factors that may influence outcome of these procedures to treat persistent AF may be patient-specific (pre-procedural),procedure-related or may involve different post-ablation followup strategies. In this review potential factors predicting recurrence of AF after ablation of persistent AF have been evaluated.In essence, data is limited mostly due to incongruent definitions of persistent AF.Left atrial dimensions, duration of continuous AF and AF cycle length may be patient-specific predictors of outcome. Intra-procedural parameters involved in recurrence prediction may be extent of ablation (effective pulmonary vein isolation appears mandatory) and termination of AF during ablation. Timing and number of cardioversion if persistent AF recurs may predict outcome, as well. Many studies have identified strators for higher recurrence rates in rather small patient groups and need to be further evaluated in larger patient collectives.

Figure 1.. Single procedure rhythm success rates 6 to 12 months after different ablation strategies for persistent AF presented in different trials (PVI + LIN: N = 417, PVI + CFAE: N= 256, PVI + LIN + CFAE: N = 341) (from 2, 3, 4, 15, 16, 17, 24, 25, 26, 27, 28, 29, 30, 31, 33, 34, 35, 36).