Pulmonary Vein Antral Isolation for Paroxysmal Atrial Fibrillation: Results from Long-Term Follow-Up

Abstract

PVAI is an effective strategy for the prevention of AF in the majority of patients with PAF. Maintenance of SR requires repeat procedure or continuation of AADs in a significant proportion of patients. After maintenance of sinus rhythm 1-year post-PVAI, a minority of patients will subsequently develop late recurrence of AF.

Catheter Ablation of Lone Atrial Fibrillation

“…Controversial data about influence of older age on the periprocedural complications were published. For example, one study showed no significant difference between major complication rates of the AF ablation in three different age groups of patients, namely <65 years, [65][66][67][68][69][70][71][72][73][74] years and ≥75 years (1.6% vs. 1.7% vs. 2.9%, p=ns) [126]. On the contrary, the other two studies demonstrated strong association between the occurrence of complication and older age of >70 and ≥75 years [127,128].…”

Long-Term Benefits Following Catheter Ablation of Atrial Fibrillation

“…In the study described by Medi et al, 22 a mean AF symptom score was calculated for each patient based on both subjective symptoms and objective measurements of AF burden, hospitalizations, and cardioversions. Among the 13 patients with recurrent paroxysmal AF at long-term follow-up, the majority still reported clinical benefit and the composite score improved from 17±2 to 10±6 (P<0.0001).…”

Can We Stop Warfarin After AF Ablation?

“…Medi et al reported that most AF/AT recurred within ≤1 year after the first procedure, and a minority of patients will subsequently develop late AF recurrence. 4 The independent predictors of late recurrence were persistent AF and a widearea pulmonary vein isolation (PVI), and a left atrium (LA) >45 mm in size was also identified as a paroxysmal AF specific predictor. 5 On the other hand, Tzou et al reported that among patients with freedom from AF at 1 year after segmental PVI, recurrence occurred constantly up to 5 years with an annual rate of 7%, in which age and persistent AF were independent risk factors.…”