Long-term PAF cessation common with pulmonary vein isolation
MedWire News: Catheter ablation by circumferential pulmonary vein isolation (CPVI) restores long-term stable sinus rhythm (SR) in most patients with paroxysmal atrial fibrillation (PAF) and normal left ventricular (LV) function, study findings suggest.
The findings also demonstrate a low 5-year risk for progression of paroxysmal- to chronic atrial fibrillation (AF) after CPVI.
This, say the study authors, suggests that chronic AF may be prevented or delayed by effective early intervention.
Feifan Ouyang (Allgemeines Krankenhaus St Georg, Hamburg, Germany) and colleagues recruited 161 symptomatic PAF patients with normal LV function.
All patients underwent CPVI and subsequent 6-monthly electrocardiography (ECG) to ascertain the presence of SR over a follow-up period of approximately 5 years.
As reported in the journal Circulation, after successful CPVI, 79.5% of patients maintained SR throughout the follow-up period. In all, 46.6%, 27.3%, and 5.6% patients required one, two, and three CPVI procedures, respectively, to achieve initial SR.
Of note, 13% of patients experienced clinical improvement despite AF recurrence after CPVI, and AF recurrence occurred more commonly during the first 3 months than at any other time during follow-up.
Progression of PAF to chronic AF occurred at a low rate of 2.4% over the 5-year follow-up.
Ouyang and colleagues comment that although their results suggest that CPVI may have a role in preventing PAF progression to chronic AF, further study is needed.
They conclude: "Other factors known to cause atrial structural remodeling (age and underlying heart disease) are involved in AF progression.
"Proper control of these factors is also of major importance."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
By Lauretta Ihonor