학술대회 안내 사전등록 안내 초록등록 안내 초록등록/관리 숙박및교통 안내


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Predictors of Recurrence of Radiofrequency Catheter Ablation of Atrial Fibrillation
고려대학교 의료원 순환기 내과
임홍의, 박희남, 고경정, 이현수, 박미영, 김진석, 안정천, 송우혁, 김영훈
Background: Catheter ablation techniques for treatment of atrial fibrillation (AF) have evolved over the past decade. However, information about the predictors for recurrence of AF after catheter ablation of AF has not been elucidated. Methods: 233 consecutive patients with paroxysmal AF (PAF, n=157) and persistent AF (PeAF, n=76) who underwent pulmonary vein isolation (PVI) by three different ablation techniques were included; 34 patients by segmental ostial ablation, 38 circumferential ostial ablation, and 161 circumferential antral ablation. Recurrence of AF was defined as AF occurring more than 3 months after ablation. The clinical variables analyzed in relation to the recurrence of AF were age, sex, left atrial dimension, left ventricular ejection fraction, presence of associated cardiovascular disease, presence of sick sinus node syndrome, presence of non-PV foci, ablation method, type of AF, and presence of early recurrence (defined as <3 month after ablation). Results: During a mean follow up of 8.7 ± 6.9 months, AF recurred in 56 (23.6%) of the 233 patients: 31.6% in PeAF vs 20.8% in PAF, (P=0.061). Fifty-five (23.6%) patients had early recurrence of AF and had a higher recurrence during follow-up compared to those without early recurrence of AF (54.5% vs 14.6%, P<0.001, respectively). Sixteen (44.1%) of 34 patients undergoing segmental ostial ablation, 12 (31.6%) of 38 circumferential ostial ablation, and 28 (18.0%) of 161 circumferential antral ablation had recurrence of AF (P=0.003). Multivariate analysis demonstrated that two clinical variables were related to the recurrence of AF: (1) presence of early recurrence (P<0.001); (2) segmental or circumferential ostial ablation (P=0.004). Conclusions: Early recurrence of AF within 3 months after ablation and ostial ablation techniques had higher recurrence rate during follow-up.


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